CRF with anemia best treatment:
Answer is B (Erythropoietin Stimulating Agents): Erythropoiesis-stimulating agents (ESAs) have emerged as the treatment of choice for anemia in chronic renal disease. Erythropoiesis-stimulating agents (ESAs) should be given to all patients with chronic kidney disease (CKD) with haemoglobin levels consistently below II g/dl. This applies equally to: Patients with CKD (stages 1-5) developing anaemia Patients with CKD stage 5 treated with haemodialysis (HD) or peritoneal dialysis (PD) Transplant patients with chronic renal insufficiency and anaemia. Strategies for treatment of Anemia in Chronic Renal Failure Erythropoiesis-stimulating agents (ESAs) Erythropoiesis-stimulating agents (ESAs) have emerged as the treatment of choice for anemia in chronic renal disease. They should be given to all patients with chronic kidney disease (CKD) with haemoglobin (Hb) levels consistently below 11 g/dl All chronic kidney disease (CKD) patients with renal anaemia undergoing treatment with an erythropoiesis-stimulating agent (ESA) should be given supplementary iron to maintain adequate bone marrow iron stores Intravenous administration is the optimum route for the delivery of iron to patients with CKD, as oral iron is poorly absorbed in uremic individuals. Blood Transfusion Red blood cell transfusions should be avoided, if at all possible, in patients with chronic kidney disease (CKD), especially those awaiting kidney transplantation. Transfusions should not be given unless patients have one or more of the following: Symptomatic anaemia (fatigue, angina, dyspnoea) and/or associated risk factors (diabetes, hea failure, coronary aery disease, aeriopathy ) Acute worsening of anaemia due to blood loss (haemorrhage or surgery) or haemolysis Severe resistance to, or hyporesponsiveness to ESA therapy, e.g. due to the presence of a haematological disease or severe inflammatory systemic disease. Androgens Prior to the introduction of ESA therapy, androgens were widely used in the treatment of renal anaemia. There is evidence that androgens may potentiate the effect of exogenous erythropoietic protein and also stimulate erythropoiesis by enhancing erythrocyte stemcell differentiation The risk of liver disease and malignancy, virilisation and hirsutism in women, priapism in men and disfiguring acne in patients of both sexes may outweigh the benefits of androgen therapy in most anaemic patients. Androgens may be an effective alternative therapy in countries where ESAs are not available
Oral Iron Therapy
Erythropoietin Stimulating Agents
Blood transfusion
Androgenic Steroids