ESA Risks, Benefits Highlighted By TREAT Study in Pre-Dialysis Patients
Although the benefit of erythropoiesis-stimulating agents (ESAs) has long been assumed, investigators do not know whether an increase of hemoglobin (Hb) levels through the use of ESAs will lower the risk for cardiovascular events and end-stage renal disease. The Trial to Reduce Cardiovascular Events with Aranesp therapy (TREAT) was designed to test this hypothesis in patients with type 2 diabetes, chronic kidney disease, and anemia who were not on dialysis. Unique in its comparison of an ESA to placebo, the results from the study by Pfeffer et al are likely to impact clinical practice to reduce risks associated with ESAs and maximize transfusion avoidance and quality of life benefits.
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Pfeffer MA, Burdmann EA, Chen CY, Cooper ME, de Zeeuw D, Eckardt KU, Feyzi JM, Ivanovich P, Kewalramani R, Levey AS, Lewis EF, McGill JB, McMurray JJ, Parfrey P, Parving HH, Remuzzi G, Singh AK, Solomon SD, Toto R; the TREAT Investigators. A Trial of Darbepoetin Alfa in Type 2 Diabetes and Chronic Kidney Disease. N Engl J Med. 2009 Oct 30.
Anemia from Declining Kidney Function 
With growing concern about this year’s flu season due to the spread of the H1N1 virus, many patients may be curious if having anemia can put them at a higher risk for complications from the flu or if they should be receiving a vaccination. This article recommends some steps you can take to prepare for flu season if you have anemia and also describes the role chronic illnesses play in causing anemia and potentially leading to serious complications from a viral infection.