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Is ESA therapy advisable for a 90 year old with grade-3 chronic kidney disease?

DOCTOR OF THE MONTH - Jul 2016
Jul 2016
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Urologist
Practicing since : 1971
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Question
Do you think at ESA therapy is a good option for a 90 yo male with CKD stage 3A? RBC count is 2.91; HGB 9.9; HCT 29.1; platelet count 104; GFR est non-AA 58; Micralb/Crea ratio (ug/mg creat) 59.0; Pt is always cold, extremely fatigued-sleeps 15 hrs/day.
Fri, 18 May 2018 in Kidney Conditions
 
 
Answered by Dr. P. T. Patil 29 hours later
Brief Answer:
ESA therapy with grade 3 CKD at the age of 90 years should be avoided .

Detailed Answer:
Hello
Thanks for query .

The primary objective in treatment of anemia in patients with Chronic Kidney Disease is to maintain hemoglobin levels at 9-12 gms.

In view of age of the patent being 90 years and considering the prevailing side effect of these drugs I would recommend not to use ESA therapy .

He can be safely managed with other anti anemic drugs and supportive supplements to improve his general condition which is known part of chronic Renal Disease .

Hope I have answered your query ,please feel free to ask if you have more questions,I shall be happy to help you
Thanks and Regards.
Dr.Patil.
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