Emrich Insa E, Böhm Michael, Heine Gunnar H
Klinik für Innere Medizin III, Klinik für Kardiologie, Angiologie und Internistische Intensivmedizin, Universitätsklinikum des Saarlandes, Homburg.
Agaplesion Markus-Krankenhaus, Medizinische Klinik II, Frankfurt am Main.
Dtsch Med Wochenschr. 2020 Dec;145(24):1775-1780. doi: 10.1055/a-1133-7849. Epub 2020 Nov 30.
Anemia and iron deficiency are highly prevalent in chronic kidney disease (CKD) and in chronic heart failure. Both may epidemiologically predict future renal and/or cardiovascular events. However, anemia treatment with either erythropoietin or erythropoiesis-stimulating agents failed to induce a prognostic benefit in either CKD or chronic heart failure. Instead, in the subgroup of chronic dialysis patients, liberal intravenous iron supplementation was beneficial, and ongoing clinical trials are testing the prognostic implication of intravenous iron supplementation in chronic heart failure. Finally, HIF stabilizers are a new treatment option for anemia in chronic kidney disease, and safety studies are currently ongoing in CKD patients. Whether patients suffering from chronic heart failure might also benefit from this treatment is currently unknown.
贫血和缺铁在慢性肾脏病（CKD）和慢性心力衰竭中极为常见。两者在流行病学上均可能预测未来的肾脏和/或心血管事件。然而，使用促红细胞生成素或促红细胞生成刺激剂进行贫血治疗，在CKD或慢性心力衰竭中均未产生预后益处。相反，在慢性透析患者亚组中，大量静脉补充铁剂是有益的，并且正在进行的临床试验正在测试静脉补充铁剂对慢性心力衰竭的预后影响。最后，低氧诱导因子稳定剂是治疗CKD贫血的一种新选择，目前正在对CKD患者进行安全性研究。患有慢性心力衰竭的患者是否也能从这种治疗中获益目前尚不清楚。
