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NEW OPTIONS FOR THE TREATMENT OF ANEMIA IN PATIENTS WITH CHRONIC KIDNEY DISEASE
PETAR KES
orcid.org/0000-0002-4501-4823
; Academy of Medical Sciences of Croatia; Faculty of Medicine, University of Zagreb, Zagreb, Croatia
Abstract
Numerous factors infl uence the development of anemia in patients with chronic kidney disease (CKD). The most signifi cant among them are absolute and functional iron defi ciency disorders, insuffi cient production of erythropoietin, permanent state of infl ammation, elevated hepcidin, factors related to the present state of hypoxia, and blood loss. The basis of today's treatment of anemia in CKD is treatment with iron preparations and use of erythropoietin. The target level of hemoglobin in most patients is 100 to 120 g/L, which is diffi cult to maintain. The treatment of anemia in patients with CKD is based on the existing guidelines issued by the Croatian Society for Nephrology, Dialysis and Transplantation, which were published in 2014, and are in accordance with the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines. In the meantime, based on numerous researches and good clinical practice, there have been changes in understanding the treatment of anemia in CKD. Prolyl hydroxylase domain hypoxia-inducible factors are a new class of oral drugs used to treat CKD anemia. Their effectiveness in achieving and maintaining the target hemoglobin value has been proven in preclinical and clinical research, which included conservatively treated or dialysis treated patients. The mentioned drugs successfully lowered the level of hepcidin and had a favorable effect on iron metabolism. Further research is under way.
Keywords
anemia; hemoglobin; hepcidin; hypoxia; inducible factors; chronic kidney disease; erythropoiesis stimulating agents; iron
Hrčak ID:
285257
URI
Publication date:
7.11.2022.
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