Transfusions have benefits and risks1-4

  • According to the National Kidney Foundation KDOQI™, despite use of pharmacologic agents for the treatment of anemia, blood transfusions are occasionally required, particularly in the setting of acute bleeding.5
  • RBC transfusions should be used judiciously in patients with CKD, especially because of the potential development of sensitivity affecting future kidney transplant.5

Benefits and risks associated with transfusions

Potential Benefits

  • Prompt increase in RBCs
  • Improved oxygen delivery to tissues
  • Avoidance of myocardial ischemia
  • Relief of acute symptoms

Potential Risks

  • Allergic reactions
  • Febrile reactions
  • Hemolytic reactions
  • Immune-related reactions, including:
    • Increased panel-reactive antibodies (PRA)
    • Transfusion-related acute lung injury (TRALI)
  • Nonimmunologic reactions (eg, fluid overload, transfusion associated circulatory/cardiovascular adverse events)
  • Infections


  • Patients with CKD and an insufficient hemoglobin response to ESA therapy may be at even greater risk for cardiovascular reactions and mortality than other patients. A rate of hemoglobin rise of > 1 g/dL over 2 weeks may contribute to these risks.
  • In controlled clinical trials, ESAs increased the risk of death in patients undergoing coronary artery bypass graft surgery (CABG) and the risk of deep venous thrombosis (DVT) in patients undergoing orthopedic procedures.

Scroll down for additional Important Safety Information

Reducing the risk of alloimmunization and/or other RBC transfusion-related risks may be a goal for patients with CKD.5,6