Department of Nephrology, Hypertension and Family Medicine, Medical University of Lodz, 90-549 Lodz, Poland.
Department of Geriatrics, National Institute of Geriatrics Rheumatology and Rehabilitation and Department of Ultrasound, Institute of Fundamental Technological Research, Polish Academy of Sciences, Warsaw, Poland (IPPT PAN), 02-106 Warsaw, Poland.
Int J Mol Sci. 2020 Jan 22;21(3):725. doi: 10.3390/ijms21030725.
Anemia is frequently observed in the course of chronic kidney disease (CKD) and it is associated with diminishing the quality of a patient's life. It also enhances morbidity and mortality and hastens the CKD progression rate. Patients with CKD frequently suffer from a chronic inflammatory state which is related to a vast range of underlying factors. The results of studies have demonstrated that persistent inflammation may contribute to the variability in Hb levels and hyporesponsiveness to erythropoietin stimulating agents (ESA), which are frequently observed in CKD patients. The understanding of the impact of inflammatory cytokines on erythropoietin production and hepcidin synthesis will enable one to unravel the net of interactions of multiple factors involved in the pathogenesis of the anemia of chronic disease. It seems that anti-cytokine and anti-oxidative treatment strategies may be the future of pharmacological interventions aiming at the treatment of inflammation-associated hyporesponsiveness to ESA. The discovery of new therapeutic approaches towards the treatment of anemia in CKD patients has become highly awaited. The treatment of anemia with erythropoietin (EPO) was associated with great benefits for some patients but not all.
贫血在慢性肾脏病（CKD）的发展过程中很常见，它会降低患者的生活质量。它还会增加发病率和死亡率，并加速 CKD 进展速度。CKD 患者常患有慢性炎症状态，这与许多潜在因素有关。研究结果表明，持续性炎症可能导致 Hb 水平的变化和对促红细胞生成素刺激剂（ESA）的低反应性，这在 CKD 患者中很常见。了解炎症细胞因子对促红细胞生成素产生和铁调素合成的影响，将有助于揭示涉及慢性病贫血发病机制的多种因素的相互作用网络。似乎针对 ESA 低反应性的抗炎和抗氧化治疗策略可能是未来治疗炎症相关的药理学干预措施的方向。人们急切地期待着针对 CKD 患者贫血的新治疗方法的发现。用促红细胞生成素（EPO）治疗贫血对一些患者有益，但并非所有患者都有效。
