Definition: A class of drugs that stimulate the bone marrow to make more red blood cells and help prevent blood transfusions. They are approved in the United States for the treatment of anemia associated with chronic kidney disease, receiving chemotherapy for cancer, and receiving AZY for HIV. Their generic names are Epotein alfa and Darbepoetin alfa but they are more commonly known by their trade names: Epogen®, Procrit®, and Aranesp®. Epotein alfa is also known by many as simply EPO.
Important Points About ESAs in Kidney Disease
- ESAs have a long and well-documented history of preventing the need for blood transfusions and improving the quality of life for kidney disease patients. ESAs have been used in chronic kidney disease for almost two decades.
- A hemoglobin (Hb) of more than 12 g/dL has been associated with a higher chance of blood clots, strokes, heart attacks, heart failure and death in chronic kidney disease patients.
- The FDA recommends ESA should be used in the lowest dose necessary to prevent blood transfusions and does not recommend a minimum hemoglobin value. Until recently, many kidney doctors targeted the hemoglobin to be greater than or equal to 11 g/dL.
- The relatively long lifespan of red blood cells (60-120 days) can make accurately dosing ESAs very difficult. Consistently having the Hb above 11 g/dL and below 12g/dL is potentially very unrealistic.
Also Known As: Epotein alfa, Epogen®, Procrit®, EPO, Darbepoetin alfa, Aranesp®