慢性肾脏病患者肾性贫血治疗的研究进展

Research progress on treatment of renal anemia in patients with chronic kidney disease

肾性贫血是慢性肾脏病(CKD)的常见并发症,严重影响患者预后。其发病机制繁杂,核心是促红细胞生成素缺乏和铁代谢障碍。多年来,该病的治疗以红细胞生成刺激剂和铁剂为主,输血作为补救治疗措施,其他治疗措施有改善营养不良、补充叶酸和维生素B12、充分透析及控制甲状旁腺功能亢进等,然而疗效并不理想。近年来,低氧诱导因子脯氨酰羟化酶抑制剂在临床应用,为肾性贫血治疗带来了又一次革新,还有研究报道了一些治疗肾性贫血的潜在方法。该文总结了近年CKD患者肾性贫血治疗的研究进展,为该病的临床治疗提供新思路。

Renal anemia is a prevalent complication of chronic kidney disease(CKD),which severely affects the prognosis of patients.The pathogenesis of renal anemia is complicated,and the core of which is erythropoietin deficiency and iron metabolism disorder.For years,renal anemia has been mainly treated based on erythropoiesis-stimulating and iron agents.Blood transfusion is used as a remedial treatment.Other therapeutic interventions include alleviating malnutrition,supplementing folic acid and vitamin Bn,adequate dialysis and controlling hyperparathyroidism,etc.,which yield low efficacy.In recent years,clinical application of hypoxia-inducible factor prolyl hydroxylase inhibitors has brought another innovation in the treatment of renal anemia,and some potential approaches for the treatment of renal anemia have been reported.In this article,recent research progresses upon the treatment of renal anemia in CKD patients were reviewed,aiming provide new ideas for clinical treatment of this disease.