Chronic kidney disease (CKD) is often complicated by anemia, which is associated with disease progression and increased hospital visits, decreased quality of life, and increased mortality.
A comprehensive literature search of English language peer-reviewed articles in PubMed/MedLine published between 1998 and 2020 related to the treatment of anemia of CKD was conducted. The United States Renal Database System and Dialysis Outcomes and Practice Patterns Study (DOPPS) data reports, the Centers for Disease Control and Prevention and the US Food and Drug Administration websites, and published congress abstracts in 2020 were surveyed for relevant information.
Subgroups of patients with anemia of CKD present a clinical challenge throughout the disease spectrum, including those with end-stage kidney disease, advanced age, or resistance to or ineligibility for current standards of care (i.e., oral or intravenous iron supplementation, erythropoietin-stimulating agents, and red blood cell transfusions). In addition, those with an increased risk of adverse events due to comorbid conditions, such as cardiovascular diseases or diabetes, comprise special populations of patients with an unmet need for interventions to improve clinical outcomes. These comorbidities must be managed in parallel and may have a synergistic effect on overall disease severity CONCLUSIONS: Several therapies provide promising opportunities to address gaps with standard of care, including hypoxia-inducible factor prolyl hydroxylase inhibitors, which stimulate hematopoiesis through promoting modest increases in serum erythropoietin and improved iron homeostasis. The critical issues in the management of anemia of CKD in these challenging phenotypes and the clinical utility of new therapeutic agents in development for the treatment of anemia of CKD should be assessed and the information should be made available to healthcare providers.

This article is protected by copyright. All rights reserved.