TITLE:
Pharmacological Adjuvants to Limit Erythropoietin Stimulating Agents Exposure
AUTHORS:
Iqbal Masood, Geoffrey Teehan
KEYWORDS:
Anemia; Chronic Kidney Disease (CKD); End Stage Renal Disease (ESRD); Erythropoiesis Stimulating Agents (ESA); Epoetin Alfa (EPO)
JOURNAL NAME:
Open Journal of Nephrology,
Vol.2 No.4,
December
18,
2012
ABSTRACT: Anemia in chronic kidney disease (CKD) is common, causing morbidity and mortality, and is primarily due to reduced erythropoietin (EPO) release and, to a lesser degree, shortened red cell survival. Erythropoietin Stimulating Agents like epoetin Alfa and darbepoetin alpha are used commonly to treat this form of anemia. Recent evidence suggests increased morbidity and mortality associated with higher hemoglobin in the setting of these agents use. Whether these complications are due to higher dose of erythropoietin or its resistance (i.e. inflammation), or achieving a higher hemoglobin remains unclear. Tightening restrictions on these agents has led to increase interest in the use of non-ESA adjuvants to improve erythropoiesis. This review will highlight the most promising of these agents.