3 Causes of this worldwide health problem primarily include a relative erythropoietin deficiency and iron deficiency. However, the availability of erythropoiesis-stimulating agents (ESAs) and iron compounds in the last twenty years have not realized the initial hopes associated with complete hemoglobin normalization in this patient group. With the

completion of several large randomized controlled trials related to CKD-anemia, an international guideline body, KDIGO (Kidney Disease: Improving Global Outcomes), thought it timely to provide updated guidance on the diagnosis, evaluation, management and treatment for all CKD patients (i.e., non-dialysis, dialysis, kidney transplant recipients and children) at risk of or with Proteasome activity anemia. To this end, the 2012 KDIGO Anemia Guideline BMN 673 addressed the risk-benefits for various therapeutic agents (iron, ESAs and other agents) in the management of CKD-anemia. A guideline is not intended to define a standard of care nor can it be construed as suggesting an exclusive course of management. Its purpose is rather to provide information so the practitioner can make an informed decision based on evidence and expert judgment. In every clinical situation, clinicians must take into account the needs of individual patients and available resources when evaluating

the appropriateness of applying guideline recommendations. This presentation will illustrate how the 2012 KDIGO guideline recommendations can be interpreted and applied in clinical settings. In addition, recommendations gathered from the recently held KDIGO Controversies Conference on Iron Management in CKD will be discussed, to better identify the ongoing unresolved issues around management of Tobramycin iron therapies in CKD and to incorporate the latest evidence and key expert opinions arisen since the guideline publication. 1 Collins AJ, Foley RN, Herzog C et al. US Renal Data System

2010 Annual Data Report. Am J Kidney Dis 2011, 57:A8. 2 Kassebaum NJ, Jasrasaria R, Naghavi M, et al. A systematic analysis of global anemia burden from 1990 to 2010. Blood. 2014; 123(5):615–624. 3 Novak JE, Yee J. Chapter 76: Anemia in Chronic Kidney Disease. In: Schrier’s Diseases of the Kidney. Coffman TM et al. (eds) p. 2238–2256, 2012. TARNG DER-CHERNG1,2 1Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, Taiwan; 2Department and Institute of Physiology, National Yang-Ming University, Taiwan Since the pioneering studies by Eschbach et al. in 1987, erythropoiesis-stimulating agents (ESAs) have become the mainstay of anemia therapy in chronic kidney disease (CKD) patients. The introduction of ESAs 23 years ago in Taiwan markedly improved the life quality of many patients undergoing dialysis, who until then had severe, often transfusion-dependent anemia.