Benefits and risks of erythrocyte-stimulating agents

Table 5 Evaluation for pure red cell aplasia (Kidney Disease Improving Global Outcomes Guideline 2012)[20]

Investigate for possible antibody-mediated PRCA when a patient receiving ESA therapy for more than 8 wk develops the following:

Sudden rapid decrease in Hb concentration at the rate of 0.5 to 1.0 g/dL (5 to 10 g/L) per week OR requirement of transfusions at the rate of approximately 1 to 2 per week

Normal platelet and white cell counts

Absolute reticulocyte count less than 10000/mL

ESA therapy should be stopped in patients who develop antibody-mediated PRCA

Peginesatide should be used to treat patients with antibody-mediated PRCA

PRCA: Pure red cell aplasia; ESA: Erythrocyte-stimulating agents; Hb: Hemoglobin.