Response to Erythropoietin Stimulating Agents in Anemia of Chronic Kidney Disease Patients

Objectives: Chronic kidney disease (CKD) encompasses a range of pathophysiologic processes related to abnormal kidney function and a gradual decline in glomerular filtration rate lasting over 3 months. Anemia is a common complication in CKD patients, typically appearing at stages 3 to 5. Erythropoietin-stimulating agents (ESAs) represent a significant advancement in managing CKD-related anemia. The objective of this study was to study the response to ESAs by anemia of CKD patients and to compare the efficacy of erythropoietin (EPO) and darbepoetin. Materials and Methods: This was an ambidirectional (prospective and retrospective) study to evaluate the response of ESAs in anemia of CKD. The study was carried out for the duration of 6 months among 150 patients with anemia of CKD at Mallige Hospital, Bengaluru, Karnataka, India. Results: Most of the patients were diagnosed with normocytic anemia (male: 49.47% and female: 45.45%) and hypochromic anemia (male: 38.95% and female: 50.91%). The baseline increment in hemoglobin (Hb) concentration by darbepoetin alpha and EPO alpha was found to be 0.86 g/dL and 0.57 g/dL, respectively ( P < 0.05). The average baseline increment in Hb concentration following ESA therapy was found to be 0.77 g/dL (male: 0.74 g/dL; female: 0.83 g/dL) ( P < 0.05). Subcutaneous route of administration accounted for 88% of the cases. Conclusion: Normocytic hypochromic anemia was found to be most common among study subjects. EPO alpha was preferred over darbepoetin alpha. The average baseline Hb concentration was found to be significantly increased following ESA administration.