title: [Erythropoietin stimulating agents in chronic kidney disease: indications and contraindications].
abstract: Erythropoietin (EPO) deficiency is important complication of chronic kidney disease. It downregulates red cells maturation and production causing renal anemia. It is associated with reduced quality of life, increased risk of blood transfusions and cardiovascular morbidity. It is possible to substitute EPOwith recombinant human EPOor its derivatives - erythropoiesis stimulating agents (ESA). ESA therapy reduces blood transfusions, improves quality of life and can raise hemoglobin to 10-11.5 g/dl. Higher hemoglobin targets bring more harm than benefit - including increased risk for stroke, hypertension and vascular access thrombosis and mortality. Initiation of ESA therapy should be preceded by excluding the other causes of anemia and balancing ESA advantages and disadvantages in every patient. In patients with previous stroke, previous or current malignancy risks of ESA therapy may outweigh the risks of red cell transfusions.
authors.affiliation: Katedra i Klinika Nefrologii, Dializoterapii i Chorób Wewnętrznych WUM, Warszawa, Polska, nefrologia@wum.edu.pl.
authors.forename: Paweł
authors.initials: P
authors.lastname: Żebrowski
authors.affiliation: Katedra i Klinika Nefrologii, Dializoterapii i Chorób Wewnętrznych WUM, Warszawa, Polska.
authors.forename: Mariusz
authors.initials: M
authors.lastname: Mieczkowski
mesh_terms: D000740:Anemia / Q000188:drug therapy* / Q000209:etiology*; D004921:Erythropoietin / Q000172:deficiency*; D006397:Hematinics / Q000627:therapeutic use*; D006801:Humans; D051436:Renal Insufficiency, Chronic / Q000150:complications*
chemical_list: D006397:Hematinics; D004921:Erythropoietin
keywords:  chronic kidney disease;  erythropoiesis stimulating agents;  erythropoietin; anemia