肾性贫血发病机制研究进展

Advances in the pathogenesis of renal anemia

肾性贫血是慢性肾脏病患者常见并发症,可加速疾病进展、增加终末期肾脏病风险、提高患者死亡率。普遍认为肾性贫血的发生主要与促红细胞生成素(EPO)不足、铁缺乏及代谢紊乱相关,本文分析缺氧诱导因子通路、铁调素-膜铁转运蛋白轴、炎症、甲状旁腺激素、成纤维细胞因子23、B型利钠肽等因素在EPO的生成、铁代谢中的作用,从而对肾性贫血发病机制的最新研究进展进行综述。

Renal anemia(RA)is a common complication in patients with chronic kidney disease(CKD),which can accelerate disease progression,increase the risk of end-stage renal disease(ESRD)and improve patient mortality.It is generally believed that the occurrence of renal anemia is mainly related to the deficiency of erythropoietin(EPO),iron deficiency and metabolic disorder.This article reviews the latest progress in the pathogenesis of renal anemia by studying how hypoxia inducible factor(HIF)pathway,hepcidin ferroportin axis,inflammation,parathyroid hormone(PTH),fibroblast growth factor 23(FGF-23),B-type natriuretic peptides(BNP)and other factors play a role in the formation of EPO and the maintenance of iron homeostasis.