Erythropoiesis-stimulating agent

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Erythropoiesis-stimulating agent, commonly abbreviated ESA, an agent similar to the cytokine (erythropoietin) that stimulates red blood cell production (erythropoeisis). ESAs, structurally and biologically, are similar to naturally occurring protein erythropoietin.

Medical uses[edit]

ESAs are used to maintain hemoglobin at the lowest level that both minimizes transfusions and best meets a person's needs.[1] Medical speciality professional organizations do not recommend the use of ESAs in people with chronic kidney disease (CKD) who have hemoglobin levels greater than 10 g/dL and do not have anemia symptoms.[1][2]

There is no evidence that one agent is better than another in the setting of CKD.[3]

Causes of ineffectiveness[edit]

  • Iron status
  • Occult blood loss
  • Vitamin B12 or folate deficiency
  • Infection and inflammation
  • Inadequate dialysis
  • Hyperparathyroidism
  • Aluminum toxicity
  • Patient adherence
  • Hypothyroidism
  • Primary disease activity
  • Transplant rejection
  • Malignancy
  • Pure red cell aplasia[4]

References[edit]

  1. ^ a b Aapro, M. S.; Link, H. (2008). "September 2007 Update on EORTC Guidelines and Anemia Management with Erythropoiesis-Stimulating Agents". The Oncologist 13: 33–36. doi:10.1634/theoncologist.13-S3-33. PMID 18458123.  edit
  2. ^ American Society of Nephrology, "Five Things Physicians and Patients Should Question", Choosing Wisely: an initiative of the ABIM Foundation (American Society of Nephrology), retrieved August 17, 2012 
  3. ^ Palmer, SC; Saglimbene, V; Mavridis, D; Salanti, G; Craig, JC; Tonelli, M; Wiebe, N; Strippoli, GF (8 December 2014). "Erythropoiesis-stimulating agents for anaemia in adults with chronic kidney disease: a network meta-analysis.". The Cochrane database of systematic reviews 12: CD010590. PMID 25486075. 
  4. ^ Burtis, C.A.; Ashwood, E.R. and Bruns, D.E. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 5th Edition. Elsevier. pp 1554

External links[edit]