Children with chronic kidney disease using any erythropoiesis-stimulating agents (ESAs), (58 studies, n= 3,895).
Systematic review assessing the efficacy of ESAs.
A total of 38 studies assessed the efficacy of recombinant human erythropoietin, 11 of darbepoetin alpha, and 3 of continuous erythropoietin receptor activator, with 6 studies appraising secondary outcome measures exclusively. The most common adverse effect was hypertension, although confounding effects often limited direct correlation. Two large cohort studies demonstrated a greater hazard of death independently associated with high ESA dose. Secondary outcome measures included quality of life measures, growth and nutrition, exercise capacity, injection site pain, cardiovascular function, intelligent quotient, evoked potentials and platelet function.