What are the potential side effects of erythropoiesis-stimulating agents (ESAs)?

Erythropoiesis-stimulating agents (ESAs) are used primarily in patients with anemia, particularly in those with chronic kidney disease or undergoing chemotherapy. The side effects associated with ESAs are an important consideration in their use.

Hypertension is a significant potential side effect of ESAs because these agents can increase hemoglobin levels, which in turn can raise blood viscosity and lead to elevated blood pressure. Patients being treated with ESAs often require regular monitoring of their blood pressure to manage this risk effectively.

The increased risk of thromboembolic events is also a noted concern. ESAs can lead to higher hematocrit levels—above 12 grams per deciliter in hemodialysis patients is a common threshold—resulting in an increased risk of blood clots. This is particularly critical in populations who may already be predisposed to thrombotic events, such as those with cardiovascular disease.

Headaches can occur due to increased blood pressure or as a direct side effect of the medication itself. It is essential for healthcare providers to inform patients about the possibility of headaches as well as the other, more serious side effects.

Understanding these potential side effects is critical for healthcare providers in order to monitor patients appropriately and adjust treatment as needed