Are there special considerations for patients with CKD and sickle cell disease?
There are no evidence-based guidelines regarding whether the anemia of patients with CKD and sickle cell disease should be treated differently from other patients with anemia and CKD.
Because of ongoing RBC destruction, patients with sickle cell disease have lower Hb levels and higher ESA requirements than their anemic CKD counterparts.
Transfusions are more often required in patients with sickle cell disease than in other patients with anemia and CKD, so attention must be paid to the potential for iron overload and sensitization for future kidney transplantation.
As in all patients, ESA and transfusion therapy in patients with sickle cell disease should carefully weigh risk versus benefit.