Anemia of chronic kidney disease

See ((Anemia of chronic disease))


The presence of anemia, as defined as the hemoglobin concentration below 13 g/dL in men and below 12 g/dL in women is approximately 30-40% in patients with moderate to advanced non-dialysis dependent chronic kidney disease.


Anemia in chronic kidney disease is associated with reduced health related quality-of-life, an increase in  red cell transfusions, and a heightened risk of cardiovascular events.


The treatment of non-dialysis dependent kidney disease patients includes correction of iron deficiency and recombinant erythropoietin and its analogues, referred to as erythropoiesis stimulating agents (ESAs).


The goal in treatment is to maintain the hemoglobin concentration within the range of 9-12 g/dL.



Treating anemia of chronic kidney disease with ESAs reduces the need for red cell  transfusion, but is associated with an increased risk of cardiovascular events when hemoglobin concentrations reach a near normal range.



The use of ESAs to target hemoglobin concentrations in the normal or normal range increases the risk of stroke, vascular access thrombosis, and death.



Hypoxemia-inducible factor (HIF) inhibitors stabilize HIF, which in turn  stimulates endogenous erythropoietin production by liver and kidneys.



Vadadustat is an oral HIV prolyl hydroxylase inhibitor found to be as efficient as darbepoeitin alpha in chronic kidney disease anemia.



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