Nakamura Makiko, Imamura Teruhiko, Sobajima Mitsuo, Kinugawa Koichiro
Second Department of Internal Medicine, University of Toyama, 2630 Sugitani Toyama-shi, Toyama, 930-0194, Japan.
Heart Vessels. 2023 Feb;38(2):284-290. doi: 10.1007/s00380-022-02181-1. Epub 2022 Oct 7.
Hypoxia-inducible factor prolyl hydroxylase (HIF-PH) inhibitors might improve renal anemia maintaining fewer cardiovascular complications. However, its safety and efficacy, as well as its impact on inflammatory biomarkers, in heart failure patients remain unknown. We initiated HIF-PH inhibitors in 13 patients with chronic heart failure and renal anemia (median age 77 years, median estimated glomerular filtration rate 24.9 mL/min/1.73m) between September 2021 and February 2022. There were no drug-related complications, except for a patient who had a headache and hot flash, resulting in discontinuation of HIF-PH inhibitor at 3 months. Among 10 patients who continued HIF-PH inhibitors for over 3 months, hemoglobin levels increased significantly (median from 9.6 g/dL to 10.7 g/dL, p = 0.004) and hepcidin-25 levels tended to decrease (median from 11.5 ng/mL to 3.0 ng/mL, p = 0.294) at 3-month follow-up. In conclusion, HIF-PH inhibitors might be safe and effective for the treatment of renal anemia in patients with chronic heart failure.
缺氧诱导因子脯氨酰羟化酶（HIF-PH）抑制剂可能改善肾性贫血，同时减少心血管并发症。然而，其在心力衰竭患者中的安全性、有效性以及对炎症生物标志物的影响仍不清楚。在2021年9月至2022年2月期间，我们对13例慢性心力衰竭合并肾性贫血患者（中位年龄77岁，中位估计肾小球滤过率24.9 mL/min/1.73m²）启用了HIF-PH抑制剂。除1例出现头痛和潮热的患者在3个月时停用HIF-PH抑制剂外，未发生与药物相关的并发症。在持续使用HIF-PH抑制剂超过3个月的10例患者中，3个月随访时血红蛋白水平显著升高（中位数从9.6 g/dL升至10.7 g/dL，p = 0.004），而铁调素-25水平呈下降趋势（中位数从11.5 ng/mL降至3.0 ng/mL，p = 0.294）。总之，HIF-PH抑制剂可能对治疗慢性心力衰竭患者的肾性贫血安全有效。
