How do you modify the hemoglobin goal and ESA dosing for patients with sickle cell anemia and ESKD on hemodialysis?

In sickle cell patients, I coordinate care with the patient's hematologist. I will reduce the hemoglobin goal to 8-10 g/dl, and if patients have a history of crises, closer to 10 g/dl, I may choose 7-9 g/dl. ESA requirements seem to be higher in sickle cell patients, so I would start with 100 units/kg IV three times weekly if using procit, or equivalent aranesp. I am not aware of any large randomized trials to corroborate this, only smaller studies such as NDT Plus 2010, 3(3):328, and a Freseniu...

I usually target a lower Hg level depending on the case. I often choose the target between 7-9 or 8-10 g/dL. Since these patients are usually also followed by hematology, I might also ask for their input.