Erythropoiesis-stimulating agent
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Erythropoiesis-stimulating agent, commonly abbreviated ESA, an agent similar to the cytokine (erythropoietin) that stimulates red blood cell production (erythropoeisis). ESAs, structurally and biologically, are similar to naturally occurring protein erythropoietin.
- Erythropoietin (Epo)
- Epoetin alfa (Procrit/Epogen)
- Epoetin beta (NeoRecormon)
- Darbepoetin alfa (Aranesp)
- Methoxy polyethylene glycol-epoetin beta (Mircera)
Medical uses
ESAs are used to maintain hemoglobin at the lowest level that both minimizes transfusions and best meets a person's needs.[1] Medical speciality professional organizations do not recommend the use of ESAs in people with chronic kidney disease (CKD) who have hemoglobin levels greater than 10 g/dL and do not have anemia symptoms.[1][2]
There is no evidence that one agent is better than another in the setting of CKD.[3]
Causes of ineffectiveness
- Iron status
- Occult blood loss
- Vitamin B12 or folate deficiency
- Infection and inflammation
- Inadequate dialysis
- Hyperparathyroidism
- Aluminum toxicity
- Patient adherence
- Hypothyroidism
- Primary disease activity
- Transplant rejection
- Malignancy
- Pure red cell aplasia[4]
References
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- ↑ Burtis, C.A.; Ashwood, E.R. and Bruns, D.E. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 5th Edition. Elsevier. pp 1554
External links
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