title: Emerging drugs for treatment of anemia of chronic kidney disease.
abstract: BACKGROUND
  Erythropoiesis-stimulating agents (ESAs) prevent transfusions among anemic patients with chronic kidney disease (CKD). Clinical trials, meta-analyses, and guidelines identify arterial and venous thromboembolism as well as myocardial event risks with the traditional ESAs, erythropoietin (EPO), and darbepoietin. Side effects of anemia treatment, considering frequency and dosage of treatment as well as targeted hemoglobin levels when utilizing ESAs, greatly impact overall well-being and the quality of life. There is a need for less frequent but equally effective ESAs in this setting.
  
  
  METHODS
  The three generations of ESAs used in CKD-associated anemia are described. Cost effectiveness of the utilization of these therapies, in addition to emerging therapies, is also presented. The few clinical and controlled trials only highlight the need for clarity in molecular biology surrounding the components that control EPO levels and utilization.
  
  
  CONCLUSIONS
  Anemia associated with CKD is an important area for development of newer therapies which are potentially safer and more convenient to administer.
authors.affiliation: The University of South Carolina, South Carolina College of Pharmacy, South Carolina Center of Economic Excellence for Medication Safety and Efficacy and the Southern Network on Adverse Reactions (SONAR) , Columbia, SC , USA.
authors.forename: Jametta S
authors.initials: JS
authors.lastname: Magwood
authors.forename: Akida
authors.initials: A
authors.lastname: Lebby
authors.forename: Brian
authors.initials: B
authors.lastname: Chen
authors.forename: Sam
authors.initials: S
authors.lastname: Kessler
authors.forename: LeAnn
authors.initials: L
authors.lastname: Norris
authors.forename: Charles L
authors.initials: CL
authors.lastname: Bennett
mesh_terms: D000740:Anemia / Q000097:blood / Q000188:drug therapy* / Q000209:etiology; D000068256:Darbepoetin alfa; D055808:Drug Discovery; D000068817:Epoetin Alfa; D004921:Erythropoietin / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006397:Hematinics / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D011788:Quality of Life; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000150:complications / Q000188:drug therapy*
chemical_list: D006397:Hematinics; D006454:Hemoglobins; D011994:Recombinant Proteins; D004921:Erythropoietin; D000068256:Darbepoetin alfa; D000068817:Epoetin Alfa