Erythropoietin-Stimulating Agents: Ongoing Concerns With Safety

摘要

Erythropoietin-stimulating agents (ESAs) have been widely used to treat anemia. Initially, their use was restricted to patients with kidney disease. More recently, they have been used for patients with other forms of anemia including myelodysplasia, persons with religious aversions to transfusion, anemia associated with critical.illness, anemia associated with cancer, and chemotherapy-induced anemia. They have also been used prior to a variety of surgery types to either increase autologous donations, or to reduce allogeneic transfusion need. ESAs produce their effect by directly interacting with bone marrow stroma where they have a variety of effects. As a result of this interaction, erythropoeisis is stimulated and the red cell count and hemoglobin levels rise.1 ESAs have dramatically changed the care of patients with chronic kidney disease, improving quality of life impairment due to anemia and reducing the need for transfusion therapy#