Badura Krzysztof, Janc Jędrzej, Wąsik Joanna, Gnitecki Szymon, Skwira Sylwia, Młynarska Ewelina, Rysz Jacek, Franczyk Beata
Department of Nephrocardiology, Medical University of Lodz, Ul. Zeromskiego 113, 90-549 Lodz, Poland.
Department of Nephrology, Hypertension and Family Medicine, Medical University of Lodz, Ul. Zeromskiego 113, 90-549 Lodz, Poland.
Biomedicines. 2024 May 27;12(6):1191. doi: 10.3390/biomedicines12061191.
Anemia is one of the most common chronic kidney disease (CKD) complications. It negatively affects patients' quality of life and clinical outcomes. The pathophysiology of anemia in CKD involves the interplay of various factors such as erythropoietin (EPO) deficiency, iron dysregulation, chronic inflammation, bone marrow dysfunction, and nutritional deficiencies. Despite recent advances in understanding this condition, anemia still remains a serious clinical challenge in population of patients with CKD. Several guidelines have been published with the aim to systematize the diagnostic approach and treatment of anemia; however, due to emerging data, many recommendations vary between publications. Recent studies indicate a potential of novel biomarkers to evaluate anemia and related conditions such as iron deficiency, which is often present in CKD patients. Our article aims to summarize the pathophysiology of anemia in CKD, as well as the diagnosis and management of this condition, including novel therapeutic approaches such as hypoxia-inducible factor-prolyl hydroxylase inhibitors (HIF-PHI). Understanding these complex subjects is crucial for a targeted approach to diagnose and treat patients with anemia in CKD effectively.
贫血是最常见的慢性肾脏病（CKD）并发症之一。它会对患者的生活质量和临床结局产生负面影响。CKD患者贫血的病理生理学涉及多种因素的相互作用，如促红细胞生成素（EPO）缺乏、铁代谢失调、慢性炎症、骨髓功能障碍和营养缺乏。尽管在理解这种情况方面最近取得了进展，但贫血在CKD患者群体中仍然是一个严峻的临床挑战。已经发布了几项指南，旨在使贫血的诊断方法和治疗系统化；然而，由于新出现的数据，许多建议在不同的出版物之间存在差异。最近的研究表明，新型生物标志物有潜力评估贫血及相关情况，如缺铁，而缺铁在CKD患者中经常存在。我们的文章旨在总结CKD患者贫血的病理生理学，以及这种情况的诊断和管理，包括新型治疗方法，如缺氧诱导因子脯氨酰羟化酶抑制剂（HIF-PHI）。了解这些复杂的主题对于有效诊断和治疗CKD患者贫血的针对性方法至关重要。
