Zadrazil Josef, Horak Pavel
Department of Internal Medicine III - Nephrology, Rheumatology and Endocrinology, Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic.
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2015 Jun;159(2):197-202. doi: 10.5507/bp.2013.093. Epub 2014 Jan 3.
Backgroud. Anemia is one of the laboratory and clinical findings of chronic kidney diseases (CKD). The presence of anemia in patients with CKD has a wide range of clinically important consequences. Some of the symptoms that were previously attributed to reduced renal function are, in fact, a consequence of anemia. Anemia contributes to increased cardiac output, the development of left ventricular hypertrophy, angina, and congestive heart failure. According to current knowledge, anemia also contributes to the progression of CKD and is one of the factors that contribute to the high morbidity and mortality in patients with chronic renal failure and their reduced survival.
MEDLINE search was performed to collect both original and review articles addressing anemia in CKD, pathophysiology of renal anemia, erythropoiesis, erythropoietin, iron metabolism, inflammation, malnutrition, drugs, renal replacement therapy and anemia management
The present review summarized current knowledge in the field of the pathophysiology of renel anemia. Understanding the pathophysiology of anemia in CKD is crucial for the optimal treatment of anemia according to recent clinical practice guidelines and recommendation, and correct recognition of causes of resistence to treatment of erythropoietin stimulating agents (ESA).
背景。贫血是慢性肾脏病(CKD)的实验室检查和临床发现之一。CKD患者贫血的存在具有一系列临床上重要的后果。一些先前归因于肾功能减退的症状,实际上是贫血的结果。贫血会导致心输出量增加、左心室肥厚、心绞痛和充血性心力衰竭的发生。根据目前的认识,贫血还会促使CKD进展,并且是导致慢性肾衰竭患者高发病率和高死亡率以及生存率降低的因素之一。
进行MEDLINE检索,以收集有关CKD贫血、肾性贫血的病理生理学、红细胞生成、促红细胞生成素、铁代谢、炎症、营养不良、药物、肾脏替代治疗和贫血管理的原始文章和综述文章。
本综述总结了肾性贫血病理生理学领域的当前知识。根据最近的临床实践指南和建议,了解CKD贫血的病理生理学对于贫血的最佳治疗以及正确认识促红细胞生成素刺激剂(ESA)治疗抵抗的原因至关重要。