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Anemia in Chronic Kidney Disease

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Approaches to Chronic Kidney Disease

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Abstract

Anemia in chronic kidney disease is a common complication associated with significant morbidity including decreased quality of life and mortality. Erythropoietin deficiency and relative iron deficiency play a significant role in its pathogenesis and their supplementation has been the cornerstone of anemia therapy in patients with advanced kidney disease. Despite anemia treatment, most of the detrimental outcomes associated with low hemoglobin levels have not improved. Goal hemoglobin levels in patients receiving renal replacement therapy (RRT) should not exceed 13 g/dL with a goal of less than 11.5 g/dL due to increased mortality from vascular events in clinical trials. Relative iron deficiency due to inability to redistribute iron from its stores in the reticulo-endothelial system is a growing cause of lower responses to erythropoietin.

Recent advances in the understanding of the pathophysiology of anemia have highlighted the role of abnormal hypoxia-inducible factor function in patients with kidney disease. New drugs that target the degradation of hypoxia-inducible factor are in clinical trials as alternative therapies to iron and erythropoietin showing encouraging results.

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Authors and Affiliations

  1. Medicine-Nephrology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA

    Maria P. Martinez Cantarin

  2. Medical Oncology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA

    Ubaldo E. Martinez Outschoorn

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Correspondence to Maria P. Martinez Cantarin .

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  1. Thomas Jefferson University, Philadelphia, PA, USA

    Jerry McCauley

  2. Department of Medicine, Division of Nephrology, Sidney Kimmel School of Medicine, Thomas Jefferson University, Philadelphia, PA, USA

    Seyed Mehrdad Hamrahian

  3. Division of Nephrology, Department of Medicine, Thomas Jefferson University, Philadelphia, PA, USA

    Omar H. Maarouf

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Martinez Cantarin, M.P., Martinez Outschoorn, U.E. (2022). Anemia in Chronic Kidney Disease. In: McCauley, J., Hamrahian, S.M., Maarouf, O.H. (eds) Approaches to Chronic Kidney Disease . Springer, Cham. https://doi.org/10.1007/978-3-030-83082-3_13

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