The development and progression of anaemia is an almost universal consequence of chronic kidney disease (CKD) and worsens with progressive loss of kidney function. Anaemia is considered both a risk marker and a risk amplifier in that it accelerates the risk of major events such as hospitalisations, stroke, myocardial infarction, and death in patients who have anaemia compared to those who do not. The mechanisms through which anaemia develops in CKD are diverse and complex. Studies over the past 20 years have elucidated mechanistic pathways and generated novel therapeutic interventions. Defective erythropoiesis, iron deficiency, and abnormal iron regulation coupled with a heightened inflammatory system have all conspired to drive the development of anaemia in CKD. The management of anaemia has been revolutionised with the wide availability of recombinant erythropoietin and increased utilisation of intravenous iron. More recently the discovery of a novel set of drugs, the hypoxia-inducible factor prolyl hydroxylase inhibitors (HIF-PHIs), has added to these treatment strategies. Optimisation of anaemia management is associated with improved quality of life, exercise tolerance, and lower risks of adverse clinical outcomes.
For verified healthcare professionals
Log in or register for free to read this article. HPN is for healthcare professionals, so new accounts are verified by our team.
