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Anemia is a common complication of chronic kidney disease (CKD). According to the National Health and Nutrition Examination Survey (NHANES), the prevalence of anemia is over 15% in US adults with CKD. As kidney function declines, anemia becomes more common: in adults with stage 4 or 5 CKD, the prevalence of anemia exceeds 50%. Among patients undergoing maintenance dialysis, anemia is nearly universal.

For decades, the primary medical treatment for anemia associated with CKD has been erythropoiesis-stimulating agents (ESAs), including epoetin alfa (Epogen), darbepoetin alfa (Aranesp), and pegylated epoetin beta (Mircera). Today, over 80% of US patients on hemodialysis use ESAs monthly, while 50% of patients on peritoneal dialysis do so. Due to long-standing concerns about cardiovascular safety, use of ESAs in patients with non–dialysis-dependent CKD is much lower. However, a new era of treatment appears imminent. A new class of medications, hydroxy-inducible factor (HIF) stabilizers, has begun to enter clinical practice in East Asia and may enter the US in the near future. Because HIF stabilizers are oral medications, the class is much more convenient to use. Nevertheless, despite many registration trials that have clearly established the efficacy of HIF stabilizers, the safety of the class relative to both placebo and ESAs remains uncertain.

CDRG has been involved in research on CKD-related anemia for more than two decades. The group has worked with multiple drug manufacturers to develop evidence about the efficacy and safety of ESAs, as well as the role of healthcare policy in shaping their use. Highlights of past work include:

Whether your company is developing new anemia medications, searching for a partner to guide post-market surveillance, or aiming to forecast the influence of a proposed payment policy on treatment use, CDRG can offer expert analysis and insight.

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Chronic Disease Research Group

Hennepin Healthcare Research Institute

701 Park Ave.

Suite S2.100

Minneapolis, MN 55415


Tel: 612.873.6200

Mon-Fri: 8:00 AM - 4:30 PM CT

The Chronic Disease Research Group (CDRG) is a division of the Hennepin Healthcare Research Institute (EIN 1568208), located in Minneapolis, MN.