Anemia in chronic kidney disease patients

Abstract

Anemia in chronic kidney disease is a common clinical problem; it is primarily due to decreased production of erythropoietin or iron deficiency state. It is a ramification of decline in functional kidney mass. Recombinant Human Erythropoietin (rHuEPO) and it analogs are the greatest tools against the anemia in chronic kidney disease patients. Last two decades of clinical experience has greatly enhanced our understanding of the potentials as well as limitations of the current EPO based therapeutic practices.

Recent studies have brought forth new therapies like HIF stabilizers, GATA inhibitor and erythropoietin gene therapy into active research in this field. These strategies are still in proof-of-concept stage and further evaluation is ongoing.

This review also briefly touches on some other relevant issues such as pitfalls of iron therapy practices; present notions about iron mediated oxidative injury to residual renal function in PD patients and iatrogenic folic acid deficiency in HD patients.