Pregledni rad
TREATMENT OF ANEMIA IN CHRONIC KIDNEY DISEASE 2021.
SANJIN RAČKI
; Klinički bolnički centar Rijeka, Zavod za nefrologiju, dijalizu i transplantaciju bubrega, Rijeka, Hrvatska
NIKOLINA BAŠIĆ-JUKIĆ
; Klinički bolnički centar Zagreb, Zavod za nefrologiju, arterijsku hipertenziju, dijalizu i transplantaciju, Zagreb, Hrvatska
INGRID PRKAČIN
; Klinička bolnica Merkur, Poliklinika, Interna klinika, Zagreb, Hrvatska
Sažetak
Multiple factors are involved in the pathogenesis of anemia in chronic kidney disease (CKD), including iron defi ciency, inadequate production of erythropoietin (Epo), hepcidin, and hypoxia-inducible factors (HIFs). Renal anemia is the result of CKD and deteriorates with disease progression. Erythropoiesis-stimulating agents administered either subcutaneously (sc.) or intravenously (iv.), along with iron therapy, are currently the cornerstones for treating anemia, but higher hemoglobin (Hb >130 g/L) increases the risk of cardiovascular and cerebrovascular events, vascular access thrombosis, progression to end-stage renal disease, and overall mortality. Treatment of anemia in patients with CKD is based on current guidelines. The latest version of Croatian guidelines for anemia was published in 2014. Since then, on the basis of research and clinical practice, there have been numerous changes in modern understanding the treatment of anemia in CKD. Hypoxia-inducible factor-prolyl hydroxylase domain inhibitors (HIF-PHIs) are a new class of orally administered drugs for the treatment of anemia in CKD. HIF-PHIs activate the HIF oxygen-sensing pathway and are effi cacious in correcting and maintaining Hb, reduce hepcidin and modulate iron metabolism, and are predicted to have effects beyond erythropoiesis. Consequently, we hereby publish a review on the recent recommendations for treating anemia in CKD 2021.
Ključne riječi
anemia; chronic kidney disease; erythropoiesis stimulating agents; iron; hepcidin; hypoxia-inducible factors
Hrčak ID:
280220
URI
Datum izdavanja:
7.7.2022.
Posjeta: 1.395 *