Waheed Yousuf Abdulkarim, Liu Jie, Almayahe Shifaa, Sun Dong
Department of Nephrology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, China.
Clinical Research Center for Kidney Disease, Xuzhou Medical University, Xuzhou, China.
Front Nephrol. 2024 Dec 23;4:1511596. doi: 10.3389/fneph.2024.1511596. eCollection 2024.
Chronic kidney disease (CKD) patients often suffer from complications such as anemia as the kidney function declines. More than 25% of CKD hemodialysis patients in China are complicated with renal anemia due to renal and hepatic impairment in the production of erythropoietin (EPO). In recent years, prolyl hydroxylase domain (PHD) inhibitors have been approved in China and Japan for the treatment of CKD patients complicated with anemia. Daprodustat is a novel orally administrated active hypoxia-induced factor-prolyl hydroxylase inhibitor (HIF-PHI) that may improve quality of life and ischemic conditions such as peripheral arterial disease (PAD), stimulate the synthesis of endogenous EPO, and can effectively induce the production of red blood cells. It has been shown to increase EPO levels, which can lead to an increase in hemoglobin (Hgb), hematocrit, and red blood cell counts. Clinical studies have shown its effectiveness in dialysis and non-dialysis CKD anemic patients. In this literature review, we will focus on the mechanism and metabolism of the drug as well as its clinical applications in dialysis and non-dialysis CKD patients and summarize the adverse reactions.
随着肾功能下降，慢性肾脏病（CKD）患者常伴有贫血等并发症。在中国，超过25%的CKD血液透析患者因促红细胞生成素（EPO）生成过程中的肾脏及肝脏损害而并发肾性贫血。近年来，脯氨酰羟化酶结构域（PHD）抑制剂已在中国和日本获批用于治疗并发贫血的CKD患者。达普司他是一种新型口服活性缺氧诱导因子脯氨酰羟化酶抑制剂（HIF-PHI），可改善生活质量及外周动脉疾病（PAD）等缺血状况，刺激内源性EPO合成，并能有效诱导红细胞生成。研究表明，它可提高EPO水平，进而使血红蛋白（Hgb）、血细胞比容及红细胞计数增加。临床研究已证实其在透析及非透析CKD贫血患者中的有效性。在这篇文献综述中，我们将聚焦于该药物的作用机制、代谢情况及其在透析和非透析CKD患者中的临床应用，并总结不良反应。
