Therapeutic advances in the management of anemia associated with chronic kidney disease: a narrative review
DOI:
https://doi.org/10.69849/m02y9h80Abstract
Anemia associated with chronic kidney disease (CKD) is a common complication of significant clinical relevance, leading to reduced quality of life, increased hospitalizations, and a higher cardiovascular risk. Its development is primarily related to erythropoietin deficiency, disturbances in iron metabolism, and persistent chronic inflammation. Although standard treatment with erythropoiesis-stimulating agents and iron supplementation has reduced the need for blood transfusions and improved clinical outcomes, important limitations remain, including therapeutic hyporesponsiveness, cardiovascular risk, and the need for parenteral administration. In this context, new pharmacological approaches have been developed, particularly hypoxia-inducible factor prolyl hydroxylase inhibitors, which act by stabilizing the hypoxia-inducible factor, thereby stimulating endogenous erythropoietin production and regulating iron homeostasis. A narrative literature review was conducted using a structured search in the PubMed database, including clinical trials, meta-analyses, and systematic reviews published over the last five years. A total of 27 articles were selected for analysis. Hypoxia-inducible factor inhibitors have demonstrated efficacy comparable to traditional therapies in increasing and maintaining hemoglobin levels, in addition to showing beneficial effects on iron metabolism and presenting an overall similar safety profile. However, long-term follow-up studies are still required to definitively confirm cardiovascular safety. In conclusion, recent advances in treatment suggest a potential transformation in the management of anemia associated with CKD.
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