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Anemia in chronic kidney disease patients: treatment recommendations and emerging therapies.

Expert review of hematology
August 1, 2014
Lucia Del Vecchio et al. (2 authors)
Journal ArticleResearch Support, Non-U.S. Gov'tReviewHuman Study
Study Details

Study Goal

The researchers aimed to explore the optimal hemoglobin targets for ESA use, safety concerns, and new strategies like HIF manipulation and activin A pathway regulation for treating anemia in CKD.

Results Summary

The study highlights unresolved questions about ESA safety and iron supplementation limits, while identifying HIF system manipulation and activin A pathway regulation as promising new approaches. New intravenous iron molecules may reduce dosing frequency.

Population

Patients with chronic kidney disease (CKD)

Effective Dosage

Not specified

Duration

Not specified

Interactions

None mentioned

Extracted Claims (6)
InterventionDirectionEndpointPopulationDosageImpactClaim #
Erythropoiesis-stimulating agents (ESA)
decrease
anemia of chronic kidney disease (CKD)
patients with chronic kidney disease
-
treat
#1
iron
decrease
anemia of chronic kidney disease (CKD)
patients with chronic kidney disease
-
treat
#2
manipulation of the hypoxia-inducible transcription factor (HIF) system
increase
erythropoiesis
-
-
promising approach to stimulate erythropoiesis
#3
regulation of activin A pathway
increase
erythropoiesis
-
-
good potential to stimulate erythropoiesis
#4
regulation of activin A pathway
increase
bone mass
-
-
additional advantage of increasing
#5
New iron molecule for intravenous administration
decrease
number of doses to be administered
-
-
may be useful to reduce
#6
Abstract

Erythropoiesis-stimulating agents (ESA) and iron have been available since decades to treat anemia of chronic kidney disease (CKD). However, many grey areas surround the field. The optimal hemoglobin (Hb) target to aimed at with ESA, the general safety of ESA and boundaries to not be exceeded with iron supplementation are still to be clearly defined. New strategies to stimulate erythropoiesis and new iron molecules have been developed; the most promising approach is the manipulation of the hypoxia-inducible transcription factor (HIF) system. The regulation of activin A pathway is another option with good potential, also considering the additional advantage of increasing bone mass. New iron molecule for intravenous administration may be useful to reduce the number of doses to be administered.

Medical Subject Headings (MeSH)
AnemiaHematinicsHumansIronRenal Insufficiency, Chronic
Study Links
Quality Scores
SafetyNot Assessed
Efficacy70/10
Quality60/10
Citation Metrics
Total Citations19
Citations/Year1.7
Relative Citation Ratio0.69
NIH Percentile36.7%
Research Impact Scores
APT Score0.50
Weight Score1.37
Normalized Score0.60