Vadadustat is approved by the FDA only for patients who have been on dialysis for at least 3 months. It is not approved for patients with CKD not on dialysis. Its efficacy and safety are comparable to that of ESAs. I would consider using vadadustat in two patient populations: those on home dialysis ...

I would use traditional ESA due to their known safety profile and reserve agent for an unresponsive patient. With more data, will likely change.