Current and Emerging Drugs in the Treatment of Anemia in Patients with Chronic Kidney Disease

Zhong, Hao‐Jie; Lin, Wen‐Shan; Zhou, Tian-Biao

doi:10.18433/jpps30919

Cited by 4 publications

(4 citation statements)

References 74 publications

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“…In addition, anemia due to folate and vitamin B12 deficiency and undergoing hemodialysis can be treated with folic acid and vitamin B12. Another therapy that can be given when the Hb level is below 7.0 g/dl is Packed Red Cells (PRC) transfusion 13,14 . Folic acid is one of the pharmacological therapies that can be given to chronic kidney disease patients.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Folic Acid Deficiency Anaemia in Predialysis Chronic Kidney Disease Patients: A Hospital-based Study

Mazumder,

Sarker,

Islam

et al. 2024

Eastern Med. Coll. J.

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Background: Chronic kidney disease (CKD) is defined as decreasing kidney function for more than 3 months. Anemia is a common complication of CKD due to a decrease in the hormone erythropoietin related to hemoglobin levels. Folic acid helps with the process of nucleoprotein synthesis and erythropoiesis maintenance.Objectives: The aim of the study was to determine the folic acid level in predialytic anaemic chronic kidney disease patients. Methodology: It was a cross-sectional study conducted in the department of Nephrology of Eastern Medical College & Hospital from September 2020 to August 2021 on predialysis CKD anaemic patient of stage-3 to stage-5. A total of 100 subjects were selected by purposive sampling. The age group was 18 to 70 years. Results: Among the 100 subjects mild, Moderate and Severe aneamia were found in 27%, 44% and 29% respectively. Maximum cases showed normocytic normochromic anaeamia (54%) and 7% cases showed macrocytic aneamia. Serum folic acid levels were found to have decreased in 1 (16.7%), 2 (8.33%) and 7 (10.0%) cases and increased in 2 (33.3%), 5 (20.83%) and 21 (30.0%) cases in stage-3, stage-4 and stage-5 respectively. Conclusion: Anemia is a frequent complication of chronic kidney disease. Inadequate production of erythropoietin by the failing kidneys leads to decreased stimulation of the bone marrow to produce red blood cells. Folic acid deficiency may represent an influential factor in renal anemia. Eastern Med Coll J. July 2023; 8 (2): 13-18

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Section: Introductionmentioning

confidence: 99%

Evaluation of Folic Acid Deficiency Anaemia in Predialysis Chronic Kidney Disease Patients: A Hospital-based Study

Mazumder,

Sarker,

Islam

et al. 2024

Eastern Med. Coll. J.

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“…However, ESAs are administrated subcutaneously or intravenously. In the long term, they most likely raise the risk of thrombosis and hypertension [ 10 , 11 ]. Moreover, some patients are resistant and hypo-response to ESAs [ 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

A network meta-analysis of the efficacy of hypoxia-inducible factor prolyl-hydroxylase inhibitors in dialysis chronic kidney disease

Shou

Jin

et al. 2023

Aging

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Background: Five types of HIF-PHIs have been authorized for anemia treatment in CKD patients in China and Japan. These are enarodustat, roxadustat, daprodustat, vadadustat, and molidustat. How effectively they compare to ESAs about clinical results in CKD-DD patients is uncertain. This study examined the RCT evidence about the benefits and risks of HIF-PHIs and ESAs in dialysis CKD patients. Methods: We conducted an extensive investigation and network meta-analysis of RCTs. In these RCTs, patients with CKD-DD received one of five different HIF-PHI or ESAs, a placebo, and no medical intervention. Outcomes included hemoglobin, iron parameters, and adverse events, and there were four weeks of follow-up at least. A frequentist framework for multivariate random effects meta-analyzed the results. The effect sizes of categorical variables were displayed as odds ratios. Mean differences were employed for computing continuous outcomes with common units; otherwise, standardized mean differences were applied. The Cochrane tool evaluated the bias risk in RCTs. Results: 26 RCTs with 14945 patients were qualified for inclusion. Compared to the placebo, HIF-PHIs and ESAs dramatically boosted hemoglobin without affecting serum iron. Roxadustat performed better hemoglobin levels than ESAs (MD 0.32, 95% CI 0.10 to 0.53) and daprodustat (0.46, 0.09 to 0.84). Roxadustat (91.8%) was the top hemoglobin treatment among all medical interventions, as determined by the SUCRA ranking. However, roxadustat caused more thrombosis and hypertension than ESAs (1.61, 1.22 to 2.12) and vadadustat (1.36, 1.01 to 1.82). The lowest rates of hypertension and thrombosis were seen in molidustat (80.7%) and ESAs (88.5%). Compared with a placebo, ESAs and HIF-PHIs all affected TSAT levels. Except for molidustat, the other four HIF-PHIs impact different iron parameters. Regarding ferritin reduction, roxadustat (90.9%) and daprodustat (60.9%) came out on top. Enarodustat (80.9%) and roxadustat (74%) placed best and second in lowering hepcidin levels. The former two medicines for TIBC improvement were vadadustat (98.7%) and enarodustat (80.9%). Conclusion: The most effective treatment for hemoglobin correction is roxadustat. The superior efficacy of reducing hepcidin makes roxadustat and enarodustat appropriate for patients with inflammation. However, the increased risk of hypertension and thrombosis associated with roxadustat should be noted. In patients at risk for hypertension and thrombosis, molidustat and ESAs may be preferable options. When administering roxadustat and daprodustat, clinicians should check ferritin to assess iron storage. Lower TSAT in patients receiving HIF-PHIs and ESAs treatment suggests intravenous iron supplements are needed.

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Section: Introductionmentioning

confidence: 99%

“…Renal anaemia is a significant complication of chronic kidney disease (CKD), imposing a heavy physiological and economic burden on patients, which has a disastrous effect on public health. 1 The definition of anaemia in CKD patients was Hb < 12 g/dl or < 12 g/dl in females and < 13.5 g/dl in males. 2 Some studies show that this kind of disease has a high prevalence, a high incidence, and a low awareness, correlating strongly with the mortality of CKD patients.…”

Section: Introductionmentioning

confidence: 99%

The relationships among gut microbiota, hypoxia‐inducible factor and anaemia with chronic kidney disease

Liu

Kong

et al. 2022

Nephrology

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Gut microbiota plays a vital role in human intestinal homeostasis, correlating strongly with the progression of numerous diseases. Recent researches provide powerful evidence that the connections exist between gut microbiota and renal anaemia. Gut microbiota may have an impact on renal anaemia by regulating the hypoxia-inducible factor (HIF) signalling, iron metabolism and inflammatory state. Because of this relationship, there may be potential treatments for renal anaemia. In this review, we will first provide an overview of current research progression on anaemia in chronic kidney disease and then introduce the relations among gut microbiota, HIF, and renal anaemia to explore the possible treatment options.

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Current and Emerging Drugs in the Treatment of Anemia in Patients with Chronic Kidney Disease

Cited by 4 publications

References 74 publications

Evaluation of Folic Acid Deficiency Anaemia in Predialysis Chronic Kidney Disease Patients: A Hospital-based Study

Evaluation of Folic Acid Deficiency Anaemia in Predialysis Chronic Kidney Disease Patients: A Hospital-based Study

A network meta-analysis of the efficacy of hypoxia-inducible factor prolyl-hydroxylase inhibitors in dialysis chronic kidney disease

The relationships among gut microbiota, hypoxia‐inducible factor and anaemia with chronic kidney disease

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