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HERO ID
7277316
Reference Type
Journal Article
Subtype
Review
Title
Red cell transfusion in chronic kidney disease in the United States in the current era of erythropoiesis stimulating agents
Author(s)
Brenner, N; Kommalapati, A; Ahsan, M; Ganguli, A
Year
2020
Is Peer Reviewed?
Yes
Journal
Journal of Nephrology
ISSN:
1121-8428
Volume
33
Issue
2
Page Numbers
267-275
Language
English
PMID
31782127
DOI
10.1007/s40620-019-00680-5
Web of Science Id
WOS:000499231800001
Abstract
Anemia is a major complication of chronic kidney disease (CKD) that leads to many symptoms of this disease and worsens cardiovascular health. Treatment of this condition was revolutionized three decades ago by the commercial availability of recombinant human erythropoietin which held the promise of completely eliminating the need for red blood cell transfusion (RBCT). Despite specific therapy now available for anemia in CKD, clinical data accumulated in the last 2 decades suggests that there is a continued need for RBCT, which, we surmise, is due to underutilization of Erythropoietin Stimulating Agents (ESA) or clinical settings such as active bleed, bone marrow resistance such as myelofibrosis or infections where ESAs are ineffective. The purpose of this narrative review is to highlight the adverse effects and summarize the current patterns of RBCT use in all stages of CKD while elaborating on the clinical characteristics of patients that increases their risks of transfusion exposure. We discuss, briefly, salient features of the pathophysiology of anemia in CKD and its contemporary therapies while presenting our perspectives on how to optimize transfusion strategies without compromising patient safety.
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