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Erythropoiesis-stimulating agents for anaemia in chronic kidney disease: Are they all the same?

Healthy kidneys produce the hormone erythropoietin, which stimulates production of red blood cells in the bone marrow. Anaemia is a common problem for people with advanced chronic kidney disease, due to reduced endogenous erythropoietin production. A new Cochrane Review by Palmer and colleagues examines the evidence for erythropoiesis-stimulating agents (ESA) for anaemia in adults with chronic kidney disease.[1] This review differs from an earlier review by some of the same authors[2] in that it employs the Bayesian statistical approach of network metaanalysis. This technique allows for both direct and indirect comparisons of different treatments for the same or similar conditions (in this case ESA for anaemia), even whenmost trials tested a treatment against placebo and did not compare treatment interventions directly.[3]