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Updated: Jun 28, 2026
07:13
Digital Home-Monitoring of Patients after Kidney Transplantation: The MACCS Platform
Published on: April 12, 2021
[Transfusion requirements in chronic kidney disease]
1Service de néphrologie, hôpitaux de Brabois, CHU de Nancy, Vandoeuvre-lès-Nancy, France. l.frimat@chu-nancy.fr
Summary
Chronic kidney disease is common in older adults, often leading to anemia. Erythropoiesis-stimulating agents (ESA) help manage anemia, but resistance can occur due to various health conditions, potentially requiring transfusions.
Area of Science:
- Nephrology
- Geriatrics
- Hematology
Context:
- Chronic kidney disease (CKD) is highly prevalent in the elderly population, affecting nearly one-third of individuals over 70.
- A significant decline in renal function is common with aging, increasing the risk of complications.
- Anemia frequently develops in CKD patients when glomerular filtration rate drops below 40 mL/min/1.73m².
Purpose:
- To explore the management of anemia in chronic kidney disease patients.
- To identify factors contributing to incomplete responses to erythropoiesis-stimulating agents (ESA) therapy.
- To discuss the implications of ESA resistance and potential need for blood transfusions.
Summary:
- Erythropoiesis-stimulating agents (ESA), alongside iron supplementation, are standard treatments for anemia in chronic kidney disease (CKD).
- However, patients may exhibit incomplete responses or resistance to ESA therapy.
- Identified causes of ESA resistance include inflammatory disorders, chronic blood loss, hyperparathyroidism, surgical stress, other chronic diseases, and immunosuppressive agent side effects.
Impact:
- Understanding ESA resistance is crucial for optimizing anemia management in CKD.
- Identifying underlying causes of resistance can guide further treatment strategies.
- This knowledge may help reduce the need for blood transfusions in CKD patients experiencing anemia.
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