Abstract
Since the introduction of recombinant human erythropoietin in the 1980s, the anemia of chronic kidney disease (CKD) can be effectively treated with erythropoiesis-stimulating agents (ESAs) and oral or intravenous iron supplementation. The majority of patients with CKD respond to such treatment; however, some patients do not respond adequately to recommended ESA or iron doses, with higher doses exposing them to an increased risk of adverse effects.1 Although on one hand complete correction of anemia paradoxically worsens patient outcomes, undertreatment of anemia is also associated with reduced quality of life, increased hospitalization rates, more blood transfusions, and higher mortality rate.
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