Hepcidin in chronic kidney disease anemia

Santos-Silva, Alice; Ribeiro, Sandra; Reis, Flávio; Belo, Luı́s

doi:10.1016/bs.vh.2019.01.012

Cited by 18 publications

(14 citation statements)

References 117 publications

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“…However, this strategy poses several clinical challenges and raises multiple patient safety concerns. Firstly, hyporesponsiveness to rhEPO is a major problem affecting 10% patients with CKD, especially in hemodialysis patients [49]; Secondly, use of ESAs in CKD anemia treatment has raised safety concerns as the development or worsening of hypertension, greater risk for death, CV events, and stroke [10,11,13,43], Thirdly, there is a serious concern about the risk and consequences of iron overload in these patients, such as liver toxicity and increased risk of infection [50]. This study indicated that both NDD-CKD and DD-CKD patients could be benefited from different HIF-PHIs in terms of anemia correction, with no obvious and intolerable adverse events.…”

Section: Discussionmentioning

confidence: 99%

Effect of hypoxia-inducible factor-prolyl hydroxylase inhibitors on anemia in patients with CKD: a meta-analysis of randomized controlled trials including 2804 patients

et al. 2020

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Section: Discussionmentioning

confidence: 99%

Effect of hypoxia-inducible factor-prolyl hydroxylase inhibitors on anemia in patients with CKD: a meta-analysis of randomized controlled trials including 2804 patients

et al. 2020

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“…Hepcidin production is stimulated by increased iron uptake and inflammation and is suppressed under conditions of iron deficiency and hypoxia [11,12]. CKD is associated with elevated hepcidin levels [13,14]. Another key element involved in iron metabolism is hypoxia-inducible factor (HIF), a transcription factor that regulates erythropoiesis through an oxygen-sensing mechanism [15,16].…”

Section: Normal Iron Metabolismmentioning

confidence: 99%

Iron Therapy in Chronic Kidney Disease: Days of Future Past

Lee

Tarng

2021

IJMS

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Anemia affects millions of patients with chronic kidney disease (CKD) and prompt iron supplementation can lead to reductions in the required dose of erythropoiesis-stimulating agents, thereby reducing medical costs. Oral and intravenous (IV) traditional iron preparations are considered far from ideal, primarily due to gastrointestinal intolerability and the potential risk of infusion reactions, respectively. Fortunately, the emergence of novel iron replacement therapies has engendered a paradigm shift in the treatment of iron deficiency anemia in patients with CKD. For example, oral ferric citrate is an efficacious and safe phosphate binder that increases iron stores to maintain hemoglobin levels. Additional benefits include reductions in fibroblast growth factor 23 levels and the activation of 1,25 dihydroxyvitamin D. The new-generation IV iron preparations ferumoxytol, iron isomaltoside 1000, and ferric carboxymaltose are characterized by a reduced risk of infusion reactions and are clinically well tolerated as a rapid high-dose infusion. In patients undergoing hemodialysis (HD), ferric pyrophosphate citrate (FPC) administered through dialysate enables the replacement of ongoing uremic and HD-related iron loss. FPC transports iron directly to transferrin, bypassing the reticuloendothelial system and avoiding iron sequestration. Moreover, this paper summarizes recent advancements of hypoxia-inducible factor prolyl hydroxylase inhibitors and future perspectives in renal anemia management.

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“…31 The high hepcidin levels often seen in CKD can contribute to functional iron deficiency. 32 Iron-deficiency anemia was also present as indicated by reduced serum iron (Table 2). Ferritin can be a misleading marker for iron deficiency as its level can raise in inflammation.…”

Section: Preoperative Management Of Anemiamentioning

confidence: 99%

How I treat anemia in the perisurgical setting

Shander

Kaufman²,

Goodnough

2020

Blood

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Anemia is a common finding in perioperative setting with significant untoward consequences including worsening of outcomes and diminished quality of life as well as increased risk of allogeneic blood transfusions. Here we present three cases that illustrate how anemia can be perioperatively managed in patients undergoing cardiac, orthopedic and oncology surgeries. Timely detection of anemia prior to high-blood loss surgeries can allow clinicians to manage it and optimize hemoglobin level, making patients better prepared for the surgery. Treatment of anemia should be guided by the etiology and may include erythropoietic agents, folic acid, B12 and iron preparations. Other blood management strategies geared toward reducing surgical blood loss such as autologous transfusion techniques and agents to optimize hemostasis are employed during surgery and in the immediate post-operative period. Patients should be closely monitored following the surgery for signs of ongoing bleeding in need of control. Finally, screening for and management of anemia should continue in the post-operative and post-discharge period, as persistence and recurrence of anemia can further undermine patient's outcomes.

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Hepcidin in chronic kidney disease anemia

Cited by 18 publications

References 117 publications

Effect of hypoxia-inducible factor-prolyl hydroxylase inhibitors on anemia in patients with CKD: a meta-analysis of randomized controlled trials including 2804 patients

Effect of hypoxia-inducible factor-prolyl hydroxylase inhibitors on anemia in patients with CKD: a meta-analysis of randomized controlled trials including 2804 patients

Iron Therapy in Chronic Kidney Disease: Days of Future Past

How I treat anemia in the perisurgical setting

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