Which is a known risk associated with ESAs?

• A. Hypotension
• B. Hyperglycemia
• C. Hypertension
• D. Hypokalemia

Answer: (C)

Erythropoiesis-stimulating agents raise red blood cell production to treat anemia, but increasing the red cell mass makes the blood thicker. That higher viscosity can raise vascular resistance and lead to elevated blood pressure. So hypertension is a known risk when using ESAs. Clinically, this is why we monitor blood pressure and carefully target hemoglobin levels instead of pushing for normal ranges. Hypotension, hyperglycemia, and hypokalemia are not typical risks associated with ESAs, though other issues can occur in the context of a patient’s overall health.