Nephrology Service, Hospital Universitario de Salamanca, Salamanca, Spain.
Rev Clin Esp (Barc). 2023 Aug-Sep;223(7):433-439. doi: 10.1016/j.rceng.2023.06.006. Epub 2023 Jun 20.
Anemia is a common complication of kidney disease and the prevalence increases as the disease progresses. It worsens the quality of life of patients and increases morbidity and mortality. The current rationale for treating renal anemia is based on the use of erythropoiesis-stimulating agents, iron supplementation and, to a lesser extent, the use of transfusions. Stimulation of endogenous erythropoietin synthesis and improvement of iron availability, through inhibition of prolil-hydroxilase-hypoxia-inducible factor (PH-HIF), represents a new oral alternative for renal anemia treatment. Clinical trials with PH-HIF inhibitors have demonstrated their efficacy in maintaining target hemoglobin levels. However, aspects concerning long-term safety are pending a clarification. In conclusion, advances in the pathogenesis of renal anemia make it possible to have current treatments to treat renal anemia. The development of new molecules, based on the inhibition of PH-HIF, represents a new effective alternative for anemia associated with kidney disease, especially in patients with resistance to erythropoiesis-stimulating agents.
贫血是肾脏疾病的常见并发症，随着疾病的进展，其患病率会增加。它会降低患者的生活质量，增加发病率和死亡率。目前治疗肾脏性贫血的依据是使用促红细胞生成素刺激剂、铁补充剂，在较小程度上还使用输血。通过抑制脯氨酰羟化酶-低氧诱导因子（PH-HIF）来刺激内源性促红细胞生成素的合成和改善铁的可用性，为肾脏性贫血的治疗提供了一种新的口服选择。PH-HIF 抑制剂的临床试验已经证明了它们在维持目标血红蛋白水平方面的疗效。然而，关于长期安全性的方面还有待澄清。总之，肾脏性贫血发病机制的研究进展使得目前的治疗方法得以治疗肾脏性贫血。基于 PH-HIF 抑制的新分子的开发为与肾脏疾病相关的贫血提供了一种新的有效替代方法，尤其是在对促红细胞生成素刺激剂有耐药性的患者中。
