Should patients with CKD receive erythropoiesis-stimulating agents?
The use of erythropoiesis-stimulating agents results in a reduced need for blood transfusions among patients with advanced CKD and has also been associated with a reduction in left ventricular hypertrophy. However, there is increasing evidence that erythropoiesis-stimulating agents should be used cautiously.
In clinical trials higher hemoglobin levels have led to an increased risk of death, stroke cardiovascular events, and hospitalization for congestive heart failure. Though treated patients in the TREAT study needed fewer transfusions and had a modest reduction in fatigue they had no benefit in other quality-of-life measures.
New England Journal of Medicine - Vol. 362, No. 1, January 7, 2010