Skip to main content

Table 7 Side effects and concomitant symptoms of erythropoiesis-stimulating agents

From: 2015 Japanese Society for Dialysis Therapy: Guidelines for Renal Anemia in Chronic Kidney Disease

Item Factor
Side effects that are supported by substantial evidence in the literature
 1. Hypertension • Blood pressure may increase because of direct or indirect effects of ESAs.
 2. Thromboembolism • The incidence of thromboembolism may increase in patients with CVD complication because of the excessive improvement in anemia (normalization of Hb level).
• An increase in the incidence of thrombosis was reported in cancer patients treated with ESAs.
 3. Pure red cell aplasia (PRCA) • PRCA develops as a result of the appearance of anti-EPO antibodies.
Side effects that are considered to be caused by ESA administration in addition to those listed above
 1. Increases in extracorporeal circulating residual blood volume and the required dose of anticoagulant • These may result from the increase in blood viscosity associated with the excessive improvement in anemia.
 2. Onset and development of solid cancer • The results of basic research showed the association of ESAs with the onset and development of cancer.