What is the indication for using erythropoietin-stimulating agents (ESAs) in chronic kidney disease?

Erythropoietin-stimulating agents (ESAs) are primarily indicated for the treatment of anemia associated with chronic kidney disease (CKD). In patients with CKD, the kidneys are often unable to produce sufficient erythropoietin, a hormone that stimulates red blood cell production in the bone marrow. As a result, individuals with CKD may develop anemia, characterized by low hemoglobin levels, fatigue, and decreased oxygen delivery to tissues.

By administering ESAs, healthcare providers can effectively increase the production of red blood cells, improving hemoglobin levels and alleviating symptoms of anemia. This treatment is critical as anemia in CKD can significantly impact a patient's quality of life and overall health. Hence, the use of ESAs directly addresses the underlying issue of anemia in patients with chronic kidney disease, making this indication vital for their management.

The other options do not align with the primary purpose of ESAs. For instance, reducing protein excretion is more related to medications that manage proteinuria rather than ESAs. Similarly, ESAs are not indicated for lowering blood pressure or preventing urinary tract infections, as these conditions require different therapeutic approaches.