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• W4230902943 abstract "We acknowledge the comments by Dr Diskin with respect to the complexity and confounding factors involved into the regulation of oxygen delivery such as acidosis, hyperphosphatemia, and maybe also the expression of erythropoietin receptors. Without any doubt, more preclinical and clinical research is needed here. It should, however, not be forgotten that the primary objective of the Anemia Correction in Diabetes (ACORD) study was to answer a clinical question raised by previously reported observational data, namely, whether higher Hb targets (Hb normalization) cause further reduction in left ventricular mass index as compared to the currently recommended lower Hb targets (partial Hb correction). In fact, our study has answered this question. By its objectives and design, however, it was never expected to answer many other scientific questions related to improved oxygen delivery (as raised by Dr Diskin) or the overall risk/benefit assessment of epoietin therapy in patients with chronic kidney disease.Letters to the Editor may be in response to an article that appeared in AJKD no more than 6 months previously, or may concern a topic of interest to current nephrology. The body of the letter should be as concise possible and in general should not exceed 250 words. Up to 10 references and 1 figure or table may be included. There is no guarantee that letters will be published. Letters are subject to editing and abridgment without notice.Letters should be submitted via AJKD’s online manuscript handling site, www.editorialmanager.com/ajkd. More information, including details about how to contact the editorial staff for assistance, is available in the journal’s Information for Authors. We acknowledge the comments by Dr Diskin with respect to the complexity and confounding factors involved into the regulation of oxygen delivery such as acidosis, hyperphosphatemia, and maybe also the expression of erythropoietin receptors. Without any doubt, more preclinical and clinical research is needed here. It should, however, not be forgotten that the primary objective of the Anemia Correction in Diabetes (ACORD) study was to answer a clinical question raised by previously reported observational data, namely, whether higher Hb targets (Hb normalization) cause further reduction in left ventricular mass index as compared to the currently recommended lower Hb targets (partial Hb correction). In fact, our study has answered this question. By its objectives and design, however, it was never expected to answer many other scientific questions related to improved oxygen delivery (as raised by Dr Diskin) or the overall risk/benefit assessment of epoietin therapy in patients with chronic kidney disease. Letters to the Editor may be in response to an article that appeared in AJKD no more than 6 months previously, or may concern a topic of interest to current nephrology. The body of the letter should be as concise possible and in general should not exceed 250 words. Up to 10 references and 1 figure or table may be included. There is no guarantee that letters will be published. Letters are subject to editing and abridgment without notice.Letters should be submitted via AJKD’s online manuscript handling site, www.editorialmanager.com/ajkd. More information, including details about how to contact the editorial staff for assistance, is available in the journal’s Information for Authors. Letters to the Editor may be in response to an article that appeared in AJKD no more than 6 months previously, or may concern a topic of interest to current nephrology. The body of the letter should be as concise possible and in general should not exceed 250 words. Up to 10 references and 1 figure or table may be included. There is no guarantee that letters will be published. Letters are subject to editing and abridgment without notice.Letters should be submitted via AJKD’s online manuscript handling site, www.editorialmanager.com/ajkd. More information, including details about how to contact the editorial staff for assistance, is available in the journal’s Information for Authors. Letters to the Editor may be in response to an article that appeared in AJKD no more than 6 months previously, or may concern a topic of interest to current nephrology. The body of the letter should be as concise possible and in general should not exceed 250 words. Up to 10 references and 1 figure or table may be included. There is no guarantee that letters will be published. Letters are subject to editing and abridgment without notice. Letters should be submitted via AJKD’s online manuscript handling site, www.editorialmanager.com/ajkd. More information, including details about how to contact the editorial staff for assistance, is available in the journal’s Information for Authors. Hitting the Target But Missing the Goal? Hemoglobin Targets Versus Oxygen DeliveryAmerican Journal of Kidney DiseasesVol. 50Issue 2PreviewI congratulate Dr Ritz for his work concerning higher hemoglobin (Hb) targets to reduce left ventricular hypertrophy1; however, even as his study reached publication, another meta-analysis concluded that higher Hb concentrations are associated with increased mortality.2 Perhaps the targeting of Hb levels might be the wrong approach. What we really should care about is oxygen delivery. Hb is merely a vehicle to achieve that delivery and the amount of vehicle necessary may change depending upon the clinical situation. Full-Text PDF" @default.
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