Which treatment is most commonly used alongside ESAs to treat anemia in chronic kidney disease?

Iron supplementation is the most commonly used treatment alongside erythropoiesis-stimulating agents (ESAs) for managing anemia in patients with chronic kidney disease (CKD). Anemia in CKD often arises due to inadequate production of erythropoietin by the diseased kidneys and can also be exacerbated by iron deficiency.

ESAs enhance the production of red blood cells, but their effectiveness can be limited in the presence of iron deficiency. Adequate iron levels are crucial for effective red blood cell production. Therefore, administering iron supplementation helps to replenish iron stores and support the action of ESAs, ensuring optimal hemoglobin levels and improving the overall management of anemia.

Folic acid supplementation, although important in various contexts of anemia, is not specifically the primary treatment used alongside ESAs in CKD. Vitamin C therapy and calcium supplementation are not routinely indicated for the treatment of anemia in this patient population.