Review article
TREATMENT OF ANEMIA IN CHRONIC KIDNEY DISEASE 2021.
SANJIN RAČKI
; Rijeka University Hospital Center, Department of Nephrology and Dialysis, Rijeka, Croatia
NIKOLINA BAŠIĆ-JUKIĆ
; Zagreb University Hospital Center, Department of Hypertension, Nephrology, Dialysis and Transplantation, Zagreb, Croatia
INGRID PRKAČIN
; Merkur University Hospital, Department of Internal Medicine, Zagreb, Croatia
Abstract
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.
Keywords
anemia; chronic kidney disease; erythropoiesis stimulating agents; iron; hepcidin; hypoxia-inducible factors
Hrčak ID:
280220
URI
Publication date:
7.7.2022.
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