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June 22, 2009

Treating Anemia With Erythropoiesis-Stimulating AgentsEffects on Quality of Life

Arch Intern Med. 2009;169(12):1100-1101. doi:10.1001/archinternmed.2009.159

Isolation and cloning of the human erythropoietin gene resulted in injectable forms of erythropoiesis-stimulating agents (ESAs) suitable for pharmacological use. This breakthrough transformed the lives of millions of individuals with chronic kidney disease (CKD) and end-stage renal disease (ESRD) worldwide. The severity and prevalence of anemia are closely associated with kidney dysfunction; the frequency of anemia increases from 27% to 76% with a decline in glomerular filtration rate1 from more than 60 mL/min/1.73 m2 to less than 15 mL/min/1.73 m2. Prior to ESAs, dialysis-associated anemia was typically treated with regular blood transfusions and anabolic steroids.2 Iron overload commonly resulted, and treated patients often had hemoglobin (Hb) concentrations lower than 10 g/dL (to convert to grams per liter, multiply by 10.0). Erythropoiesis-stimulating agents currently available in the United States include epoetin alfa and darbepoetin alfa, and their differential carbohydrate content determines plasma half-life and dosing interval.

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