VIDEO: Best treatment for anemia in CKD starts with slowing down progressive renal failure

Editor’s note: This is a previously posted video, and the below is an automatically generated transcript to be used for informational purposes. Please notify editor@healio.com if there are concerns regarding accuracy of the transcription.

The best treatment begins with just focusing on slowing down progressive renal failure, and that means using ACE inhibitors or ARBs combined with an SGLT2. If you're talking about stage three and beyond CKD, these patients are at great risk of progression and those drugs have been shown to slow down progressive renal failure. What most people don't realize is they've also been shown to increase hemoglobin. They increase hemoglobin about 0.6 grams per deciliter, which is substantial, and they appear to do it by enhancing mobilization of iron. So, the major cause of these patients being anemic is iron deficiency and this helps treat 'em. So that's the very first step. If you're doing that, you'll actually run into less anemia in your patients.

The second is almost reflexively if you find anemia is to look at whether they're iron deficient. There are many ways to treat it, both with oral iron and with IV therapies, and that's really the second main step. If you're doing that well, occasionally, you'll have patients, usually in stage four or five CKD, who still have a hemoglobin less than 10, assuming you've excluded other diseases like myeloma or something to cause their anemia, these patients are good candidates for starting on ESA therapy or erythropoiesis stimulating agents.