Volume 86, Issue 1, Pages 34-39 (July 2014) Treatment with erythropoiesis-stimulating agents in chronic kidney disease patients with cancer  Azzour D. Hazzan, Hitesh H. Shah, Susana Hong, Vipulbhai Sakhiya, Rimda Wanchoo, Steven Fishbane  Kidney International  Volume 86, Issue 1, Pages 34-39 (July 2014) DOI: 10.1038/ki.2013.528 Copyright © 2014 International Society of Nephrology Terms and Conditions

Figure 1 Approach to issues related to cancer in CKD/ESRD patients treated with ESAs. APPRISE, Assisting Providers and cancer Patients with Risk information for the Safe use of ESAs; CKD, chronic kidney disease; ESA, erythropoiesis-stimulating agents; ESRD, end-stage renal disease; Hgb, hemoglobin; REMS, risk evaluation and mitigation strategy. Kidney International 2014 86, 34-39DOI: (10.1038/ki.2013.528) Copyright © 2014 International Society of Nephrology Terms and Conditions

Figure 2 The literature of ESA treatment to high Hgb targets in CKD/ESRD as well as in cancer has indicated an increased risk of adverse outcomes. It is possible, but not proven, that the high Hgb level or the high ESA dose required may be part of the causal pathway. To the extent that this is true, lower Hgb targets may decrease the risk for adverse outcomes while still achieving the beneficial effects of treatment. CKD, chronic kidney disease; ESA, erythropoiesis-stimulating agents; ESRD, end-stage renal disease; Hgb, hemoglobin. Kidney International 2014 86, 34-39DOI: (10.1038/ki.2013.528) Copyright © 2014 International Society of Nephrology Terms and Conditions