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For Some on Dialysis, Anemia Drugs Pose Risks
Date:3/2/2010

But experts say not using them would lower people's quality of life,,

TUESDAY, March 2 (HealthDay News) -- Powerful drugs that treat the anemia caused by kidney failure yield mixed results, depending on the severity of the anemia, a new study has shown.

People on dialysis with severe anemia, according to the study, tend to live longer when given high doses of the drugs -- known as erythropoiesis-stimulating agents (ESAs) and marketed as Epogen, Procrit and Aranesp. But it found that the drugs increase the risk for dying prematurely among people with mild anemia.

ESAs, which increase the production of red blood cells, are approved by the U.S. Food and Drug Administration to treat the anemia caused by cancer chemotherapy and AIDS drugs as well as kidney failure. But safety concerns have limited their use, especially among cancer patients.

Over the next few months, the FDA and the U.S. Centers for Medicare and Medicaid Services plan to review the use of ESAs in the treatment of anemic people with kidney disease. The researchers noted that ESAs are the most expensive drugs approved by Medicare for people needing long-term dialysis, with the agency spending about $2 billion a year on them.

"ESAs are the mainstay of treatment in these patients," said study author Dr. Wolfgang C. Winkelmayer, an associate professor of nephrology at Stanford University School of Medicine. "Almost 95 percent of those patients receive them."

By taking ESAs, people on dialysis who are anemic need fewer blood transfusions.

"What we did learn from our study," Winkelmayer said, "is that there is actually a benefit in mortality if you treat aggressively at the low end of hematocrits," which refers to the percent of blood that's made up of red cells.

"These findings clearly justify the use of ESAs beyond just to avoid transfusions, and using ESA might be good practice," he said.

The findings are re
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8. Large Study of Anemia Treatment in Chronic Kidney Disease Patients Not on Dialysis Published in the New England Journal of Medicine Failed to Meet Primary Efficacy Endpoints
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