EPIDEMIOLOGY AND PREVENTION: Edited by Navdeep TangriAnemia management in dialysis patients a PIVOT and a new path?Nair, Sanjeeva; Trivedi, MayuribAuthor Information aDepartment of Nephrology, Saveetha Medical College Hospital, Chennai, Tamil Nadu bSection of Nephrology, Hinduja Healthcare Surgical, Khar, Khar West, Mumbai, Maharashtra, India Correspondence to Sanjeev Nair, Department of Nephrology, Saveetha Medical College Hospital, Saveetha University, Thandalam, Chennai, Tamil Nadu 602105, India. Tel: +91 44 66726619; fax: +91 44 66726623; e-mail: email@example.com Current Opinion in Nephrology and Hypertension: May 2020 - Volume 29 - Issue 3 - p 351-355 doi: 10.1097/MNH.0000000000000607 Buy Metrics Abstract Purpose of review We will examine the current and future options in management of anemia in dialysis patients focusing on recent trials in iron supplementation and alternatives to erythropoietin-stimulating agents (ESAs). Recent findings We review the literature on Erythropoietin (EPO)-stimulating agents, focusing on the risk benefits of various options available. We review the recent practice changing trial in iron supplementation in dialysis patients with chronic kidney disease and movements in the research on alternatives to EPO-stimulating agents primarily hypoxia-inducible factor prolyl hydroxylase inhibitors (HIF-PHIs). Summary ESAs constitute the mainstay of treatment of anemia in dialysis and evidence does not support the preference of any one type over the other. But concerns exist about the cardiovascular safety of supra-physiological ESA levels. Iron supplementation has been shown to be a well tolerated method to decrease ESA doses while maintaining hemoglobin levels and recent evidence should result in a revisiting of the guidelines for iron supplementation. HIF-PHIs are potentially safe alternatives to ESAs that correct and maintain hemoglobin while maintaining physiological levels of erythropoietin. Ongoing phase III trials for these drugs will likely answer questions of long-term safety regarding these drugs. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.