increased no. of RBCs/ hemoglobin; decreases likelihood of blood transfusions
What are the advantages of ESAs? (2)
Hgb < 10g/dL
When do we initiate an ESA in Non-Dialysis patients?
Hgb 9-10 g/dL
When do we initiate an ESA in HD patients?
>11.5 g/dL
What hemoglobin level do we have to avoid with ESAs?
hypertension, infusion reaction, PRCA
What are AE's of ESAs? (3)
patient on ESA > 8 weeks + rapid drop in Hgb w low reticulocytes
When do we suspect a PRCA reaction?
1-2 g/dL per month
What is our goal rate of for hemoglobin increase?
no sooner than every 4 weeks; may increase dose by 25% if Hgb doesn't increase after 1 month
When can we increase the dose of an ESA?
reduce by 25% if Hgb increases > 1 g/dL in 2 weeks; if HgB > 11.5 g/dL
When do we reduce the dose of an ESA? (2)
iron, B12, folate deficiency; chronic bleeding, ACEi/ARB
What can cause hyporesponsiveness to ESAs? (5)
anemia of CKD + dialysis
What is the indication for Daprodustat?
iron deficiency
What should be treated before starting an ESA?