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Red cell transfusion in chronic kidney disease in the United States in the current era of erythropoiesis stimulating agents
- Source :
- Journal of Nephrology. 33:267-275
- Publication Year :
- 2019
- Publisher :
- Springer Science and Business Media LLC, 2019.
-
Abstract
- Anemia is a major complication of chronic kidney disease (CKD) that leads to many symptoms of this disease and worsens cardiovascular health. Treatment of this condition was revolutionized three decades ago by the commercial availability of recombinant human erythropoietin which held the promise of completely eliminating the need for red blood cell transfusion (RBCT). Despite specific therapy now available for anemia in CKD, clinical data accumulated in the last 2 decades suggests that there is a continued need for RBCT, which, we surmise, is due to underutilization of Erythropoietin Stimulating Agents (ESA) or clinical settings such as active bleed, bone marrow resistance such as myelofibrosis or infections where ESAs are ineffective. The purpose of this narrative review is to highlight the adverse effects and summarize the current patterns of RBCT use in all stages of CKD while elaborating on the clinical characteristics of patients that increases their risks of transfusion exposure. We discuss, briefly, salient features of the pathophysiology of anemia in CKD and its contemporary therapies while presenting our perspectives on how to optimize transfusion strategies without compromising patient safety.
- Subjects :
- Nephrology
medicine.medical_specialty
Anemia
030232 urology & nephrology
Disease
030204 cardiovascular system & hematology
03 medical and health sciences
0302 clinical medicine
Renal Dialysis
hemic and lymphatic diseases
Internal medicine
Humans
Medicine
Renal Insufficiency, Chronic
Intensive care medicine
Adverse effect
Myelofibrosis
business.industry
medicine.disease
United States
Erythropoietin
Hematinics
Erythropoiesis
Erythrocyte Transfusion
business
medicine.drug
Kidney disease
Subjects
Details
- ISSN :
- 17246059 and 11218428
- Volume :
- 33
- Database :
- OpenAIRE
- Journal :
- Journal of Nephrology
- Accession number :
- edsair.doi.dedup.....3e72d3879ee1d9b8628cc47202c89224