What is the purpose of erythropoiesis-stimulating agents (ESAs) in CKD?

• A. Increase white blood cell production
• B. Increase platelet production
• C. Stimulate red blood cell production
• D. Lower cholesterol

Answer: (C)

In CKD, anemia arises because damaged kidneys produce less erythropoietin, the hormone that signals the bone marrow to make red blood cells. Erythropoiesis-stimulating agents mimic that signal, stimulating the bone marrow to increase red blood cell production. This raises hemoglobin, improves oxygen delivery to tissues, and helps lessen symptoms like fatigue, also reducing the need for red blood cell transfusions. They are given by injection and work best when iron stores are adequate, since iron is a key building block for new red cells. It’s important to monitor for safety, as pushing hemoglobin too high can raise blood pressure and increase thrombotic risks.

Other choices don’t fit because the goal of ESAs is to boost red blood cell production, not white blood cells or platelets, and they don’t have a role in lowering cholesterol.