Bhandari Sunil, Spencer Sebastian, Oliveira Ben, Mikhail Ashraf, Brooks Owain, Bryant Gareth, Willicombe Michelle, Baines Richard, Alldridge Louise, Haslam-England Sally
Hull University Teaching Hospitals NHS Trust, Hull, UK.
Barts Health NHS Trust, London, UK.
BMC Nephrol. 2025 Apr 16;26(1):193. doi: 10.1186/s12882-025-04115-1.
Anaemia is common in chronic kidney disease (CKD) encompassing non-dialysis dependent CKD (NDD-CKD) and dialysis dependent CKD (DD-CKD); people on peritoneal dialysis (PD) and haemodialysis (HD); and kidney transplant recipients (KTR). Iron deficiency and erythropoietin deficiency are the most common causes of anaemia in people with CKD, especially those requiring kidney replacement therapy (KRT). The Renal National Service Framework and National Institute for Health and Clinical Excellence in the UK, and Kidney Disease Improving Global Outcomes (KDIGO), all advocate treatment of anaemia in people with CKD. Blood transfusions are infrequently required, and newer therapies such as Hypoxia-Inducible Factor (HIF-PHI) stabilisers are now in current use. This guideline provides evidence based graded practice guidance on the use of iron; comments on iron deficiency without anaemia in people with CKD; provide further information on anaemia management in people with a transplant and provide guidance in the use of the new HIF-PHI drugs. It also provides audit and research recommendations.
贫血在慢性肾脏病(CKD)中很常见,包括非透析依赖型慢性肾脏病(NDD-CKD)和透析依赖型慢性肾脏病(DD-CKD);接受腹膜透析(PD)和血液透析(HD)的患者;以及肾移植受者(KTR)。缺铁和促红细胞生成素缺乏是慢性肾脏病患者贫血的最常见原因,尤其是那些需要肾脏替代治疗(KRT)的患者。英国的《肾脏国家服务框架》和国家卫生与临床优化研究所,以及改善全球肾脏病预后组织(KDIGO),都提倡对慢性肾脏病患者进行贫血治疗。很少需要输血,目前正在使用诸如缺氧诱导因子(HIF-PHI)稳定剂等新疗法。本指南提供了关于铁使用的循证分级实践指导;对慢性肾脏病患者无贫血的缺铁情况进行评论;提供关于移植患者贫血管理的更多信息,并提供使用新型HIF-PHI药物的指导。它还提供了审核和研究建议。