Kidney International Supplements最新文献_第6页

IF 5.5 2区医学

Kidney International Supplements Pub Date : 2021-04-01 DOI: 10.1016/S2157-1716(21)00023-X

引用次数: 0

Iron metabolism and management: focus on chronic kidney disease 铁代谢和管理:关注慢性肾脏疾病

IF 5.5 2区医学

Kidney International Supplements Pub Date : 2021-04-01 DOI: 10.1016/j.kisu.2020.12.003

Anil K. Agarwal

{"title":"Iron metabolism and management: focus on chronic kidney disease","authors":"Anil K. Agarwal","doi":"10.1016/j.kisu.2020.12.003","DOIUrl":"10.1016/j.kisu.2020.12.003","url":null,"abstract":"<div><p>Anemia is common in patients with chronic kidney disease (CKD) and results from the dysregulation of iron metabolism and erythropoiesis. Hepcidin is a key regulator of iron availability and leads to iron sequestration during the state of iron repletion. Decreases in the level of hepcidin in the presence of hypoxia and/or iron limitation allow for greater iron availability for erythropoiesis. However, kidney excretion of hepcidin decreases as the severity of CKD increases, whereas production of hepcidin is increased under inflammatory conditions often present in patients with CKD, both of which contribute to anemia. Assessment of iron status is, therefore, essential in the treatment of anemia. However, current laboratory tests for the determination of the adequate supply of iron have many limitations, including diurnal variation in the levels of biomarkers, lack of standardized reference methods across laboratories, and confounding by the presence of inflammation. In addition, the current treatment paradigm for anemia of CKD can further disrupt iron homeostasis; for example, treatment with erythropoiesis-stimulating agents in the absence of supplemental iron can induce functional iron deficiency. Moreover, supplemental iron can further increase levels of hepcidin. Several novel therapies, including hypoxia-inducible factor prolyl hydroxylase inhibitors and hepcidin inhibitors/antagonists, have shown promise in attenuating the levels and/or activity of hepcidin in anemia of CKD, thus ensuring the availability of iron for erythropoiesis.</p></div>","PeriodicalId":48895,"journal":{"name":"Kidney International Supplements","volume":"11 1","pages":"Pages 46-58"},"PeriodicalIF":5.5,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.kisu.2020.12.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25525799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 21

Anemia management for home dialysis including the new US public policy initiative 家庭透析的贫血管理，包括新的美国公共政策倡议

IF 5.5 2区医学

Kidney International Supplements Pub Date : 2021-04-01 DOI: 10.1016/j.kisu.2020.12.005

Anjay Rastogi , Edgar V. Lerma

{"title":"Anemia management for home dialysis including the new US public policy initiative","authors":"Anjay Rastogi , Edgar V. Lerma","doi":"10.1016/j.kisu.2020.12.005","DOIUrl":"10.1016/j.kisu.2020.12.005","url":null,"abstract":"<div><p>Patients with end-stage kidney disease (ESKD) requiring kidney replacement therapy are often treated in conventional dialysis centers at substantial cost and patient inconvenience. The recent United States Executive Order on Advancing American Kidney Health, in addition to focusing on ESKD prevention and reforming the kidney transplantation system, focuses on providing financial incentives to promote a shift toward home dialysis. In accordance with this order, a goal was set to have 80% of incident dialysis patients receiving home dialysis or a kidney transplant by 2025. Compared with conventional in-center therapy, home dialysis modalities, including both home hemodialysis and peritoneal dialysis, appear to offer equivalent or improved mortality, clinical outcomes, hospitalization rates, and quality of life in patients with ESKD in addition to greater convenience, flexibility, and cost-effectiveness. Treatment of anemia, a common complication of chronic kidney disease, may be easier to manage at home with a new class of agents, hypoxia-inducible factor-prolyl hydroxylase inhibitors, which are orally administered in contrast to the current standard of care of i.v. iron and/or erythropoiesis-stimulating agents. This review evaluates the clinical, quality-of-life, economic, and social aspects of dialysis modalities in patients with ESKD, including during the coronavirus disease 2019 pandemic; explores new therapeutics for the management of anemia in chronic kidney disease; and highlights how the proposed changes in Advancing American Kidney Health provide an opportunity to improve kidney health in the United States.</p></div>","PeriodicalId":48895,"journal":{"name":"Kidney International Supplements","volume":"11 1","pages":"Pages 59-69"},"PeriodicalIF":5.5,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.kisu.2020.12.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25525801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Title Page 标题页

IF 5.5 2区医学

Kidney International Supplements Pub Date : 2021-04-01 DOI: 10.1016/S2157-1716(21)00024-1

引用次数: 0

The evolving science of anemia management in chronic kidney disease 慢性肾脏疾病贫血管理科学的发展

IF 5.5 2区医学

Kidney International Supplements Pub Date : 2021-04-01 DOI: 10.1016/j.kisu.2020.11.002

Ziad A. Massy , Tilman B. Drueke

引用次数: 2

Hypoxia-inducible factor–prolyl hydroxylase inhibitors in the treatment of anemia of chronic kidney disease 缺氧诱导因子-脯氨酸羟化酶抑制剂治疗慢性肾病贫血

IF 5.5 2区医学

Kidney International Supplements Pub Date : 2021-04-01 DOI: 10.1016/j.kisu.2020.12.002

Volker H. Haase

{"title":"Hypoxia-inducible factor–prolyl hydroxylase inhibitors in the treatment of anemia of chronic kidney disease","authors":"Volker H. Haase","doi":"10.1016/j.kisu.2020.12.002","DOIUrl":"10.1016/j.kisu.2020.12.002","url":null,"abstract":"<div><p>Hypoxia-inducible factor–prolyl hydroxylase domain inhibitors (HIF-PHIs) are a promising new class of orally administered drugs currently in late-stage global clinical development for the treatment of anemia of chronic kidney disease (CKD). HIF-PHIs activate the HIF oxygen-sensing pathway and are efficacious in correcting and maintaining hemoglobin levels in patients with non–dialysis- and dialysis-dependent CKD. In addition to promoting erythropoiesis through the increase in endogenous erythropoietin production, HIF-PHIs reduce hepcidin levels and modulate iron metabolism, providing increases in total iron binding capacity and transferrin levels, and potentially reducing the need for i.v. iron supplementation. Furthermore, HIF-activating drugs are predicted to have effects that extend beyond erythropoiesis. This review summarizes clinical data from current HIF-PHI trials in patients with anemia of CKD, discusses mechanisms of action and pharmacologic properties of HIF-PHIs, and deliberates over safety concerns and potential impact on anemia management in patients with CKD.</p></div>","PeriodicalId":48895,"journal":{"name":"Kidney International Supplements","volume":"11 1","pages":"Pages 8-25"},"PeriodicalIF":5.5,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.kisu.2020.12.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25525347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 67

Anemia of cardiorenal syndrome 心肾综合征贫血

IF 5.5 2区医学

Kidney International Supplements Pub Date : 2021-04-01 DOI: 10.1016/j.kisu.2020.12.001

Peter A. McCullough

{"title":"Anemia of cardiorenal syndrome","authors":"Peter A. McCullough","doi":"10.1016/j.kisu.2020.12.001","DOIUrl":"10.1016/j.kisu.2020.12.001","url":null,"abstract":"<div><p>Cardiorenal syndrome includes a spectrum of disorders of the kidneys and heart in which loss of function in one organ contributes to reduced function in the other organ. Cardiorenal syndrome is frequently complicated by comorbid anemia, which leads to reciprocal and progressive cardiac and renal deterioration. The triad of heart failure, chronic kidney disease (CKD), and anemia is termed cardiorenal anemia syndrome (CRAS). There are currently no evidence-based recommendations for managing patients with CRAS; however, the treatment of these patients is multifactorial. Not only must the anemia be controlled, but heart failure and kidney injury must be addressed, in addition to other comorbidities. Intravenous iron and erythropoiesis-stimulating agents are the mainstays of treatment for anemia of CKD, addressing both iron and erythropoiesis deficiencies. Since erythropoiesis-stimulating agent therapy can be associated with adverse outcomes at higher doses in patients with CKD and is not used in routine practice in patients with heart failure, treatment options for managing anemia in patients with CRAS are limited. Several new therapies, particularly the hypoxia-inducible factor–prolyl hydroxylase inhibitors, are currently under clinical development. The hypoxia-inducible factor–prolyl hydroxylase inhibitors have shown promising results for treating anemia of CKD in clinical trials and may confer benefits in patients with CRAS, potentially addressing some of the limitations of erythropoiesis-stimulating agents. Updated clinical practice guidelines for the screening and management of anemia in cardiorenal syndrome, in light of potential new therapies and clinical evidence, would improve the clinical outcomes of patients with this complex syndrome.</p></div>","PeriodicalId":48895,"journal":{"name":"Kidney International Supplements","volume":"11 1","pages":"Pages 35-45"},"PeriodicalIF":5.5,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.kisu.2020.12.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25525798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 23

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IF 5.5 2区医学

Kidney International Supplements Pub Date : 2020-12-01 DOI: 10.1016/S2157-1716(20)30025-3

引用次数: 0

Corrigendum to “Tonelli M, Nkunu V, Varghese C, et al. Framework for establishing integrated kidney care programs in low- and middle-income countries” Kidney Int Suppl. 2020;10:e19–e23 “Tonelli M，Nkunu V，Varghese C等人在中低收入国家建立综合肾脏护理计划的框架”肾脏国际增刊2020的勘误表；10:e19–e23

IF 5.5 2区医学

Kidney International Supplements Pub Date : 2020-12-01 DOI: 10.1016/j.kisu.2020.11.001

Marcello Tonelli , Victoria Nkunu , Cherian Varghese , Ali K. Abu-Alfa , Mona N. Alrukhaimi , Bassam Bernieh , Louise Fox , John Gill , David C.H. Harris , Fan Fan Hou , Philip J. O’Connell , Harun Ur Rashid , Abdou Niang , Shahrzad Ossareh , Vladimir Tesar , Elena Zakharova , Chih-Wei Yang

引用次数: 0

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IF 5.5 2区医学

Kidney International Supplements Pub Date : 2020-12-01 DOI: 10.1016/s2157-1716(20)30025-3

引用次数: 0