Analysis of trends and variability of precipitation in the southeastern basins of Ecuador
DOI:
https://doi.org/10.62452/txjcmm78Keywords:
Anemia, chronic kidney disease, erythropoietin, intravenous iron, individualized treatmentAbstract
Anemia secondary to chronic kidney disease (CKD) is a common and progressive complication that significantly affects patients' quality of life and prognosis. Its multifactorial pathophysiology—primarily driven by erythropoietin deficiency and disruptions in iron metabolism—requires a comprehensive clinical approach that encompasses early diagnosis and therapeutic strategies tailored to each stage of CKD. This review examines current strategies for early identification of renal anemia, including emerging biomarkers, and evaluates the efficacy of modern treatments such as erythropoiesis-stimulating agents, intravenous iron therapies, and new modulators of the HIF pathway. Additionally, the review emphasizes individualized therapy based on clinical profiles and cardiovascular risk. A timely and stratified approach can reduce complications, enhance functional capacity, and improve outcomes in this high-risk patient population.
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References
Aguiar Hazin, M. A. (2020). Anemia in chronic kidney disease. Revista da Associação Médica Brasileira, 66(Suppl 1), 55–58. https://doi.org/10.1590/1806-9282.66.S1.55
Ammirati, A. L. (2020). Chronic kidney disease. Revista da Associação Médica Brasileira, 66(Suppl 1), 03–09. https://doi.org/10.1590/1806-9282.66.S1.3
Babitt, J. L., Eisenga, M. F., Haase, V. H., Kshirsagar, A. V., Levin, A., Locatelli, F., Małyszko, J., Swinkels, D. W., Tarng, D.-C., Cheung, M., Jadoul, M., Winkelmayer, W. C., & Drüeke, T. B. (2021). Controversies in optimal anemia management: Conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Conference. Kidney International, 99(6), 1280–1295. https://doi.org/10.1016/j.kint.2021.03.020
Carlucci, A. M., Cervellera, C. P., De Sa Sampayo, C. M., De Vito, A., Villafañe, C. A., Martín, C. J., & Sterin Prync, A. E. (2020). Aportes de la biotecnología al diagnóstico y tratamiento de la enfermedad renal crónica y comorbilidades frecuentes. Revista del Hospital Italiano de Buenos Aires, 40(3), 105–116. https://ojs.hospitalitaliano.org.ar/index.php/revistahi/article/view/456
Cases, A., Egocheaga, M. I., Tranche, S., Pallarés, V., Ojeda, R., Górriz, J. L., & Portolés, J. M. (2018). Anemia of chronic kidney disease: Protocol of study, management and referral to Nephrology. Nefrología, 38(1), 8–12. https://doi.org/10.1016/j.nefro.2017.09.004
Chen, N., Hao, C., Peng, X., Lin, H., Yin, A., Hao, L., Tao, Y., Liang, X., Liu, Z., Xing, C., Chen, J., Luo, L., Zuo, L., Liao, Y., Liu, B.-C., Leong, R., Wang, C., Liu, C., Neff, T., Szczech, L., & Yu, K.-H. (2019). Roxadustat for anemia in patients with kidney disease not receiving dialysis. The New England Journal of Medicine, 381(11), 1001–1010. https://doi.org/10.1056/NEJMoa1813599
Hanna, R. M., Streja, E., & Kalantar-Zadeh, K. (2021). Burden of anemia in chronic kidney disease: Beyond erythropoietin. Advances in Therapy, 38(1), 52–75. https://doi.org/10.1007/s12325-020-01524-6
Heras-Benito, M. (2023). Renal anemia: Current treatments and emerging molecules. Revista Clínica Española (Barcelona), 223(7), 433–439. https://doi.org/10.1016/j.rceng.2023.06.006
Kidney Disease: Improving Global Outcomes-CKD Work Group. (2024). KDIGO 2024 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney International, 105(4S), S117–S314. https://doi.org/10.1016/j.kint.2023.10.018
Ku, E., Del Vecchio, L., Eckardt, K.-U., Haase, V. H., Johansen, K. L., Nangaku, M., Tangri, N., Waikar, S. S., Więcek, A., Cheung, M., Jadoul, M., Winkelmayer, W. C., & Wheeler, D. C. (2023). Novel anemia therapies in chronic kidney disease: Conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference. Kidney International, 104(4), 655–680. https://doi.org/10.1016/j.kint.2023.05.009
Kuragano, T. (2024). Treatment of anemia associated with chronic kidney disease: Plea for considering physiological erythropoiesis. International Journal of Molecular Sciences, 25(13), 7322. https://doi.org/10.3390/ijms25137322
Lok, C. E., Huber, T. S., Lee, T., Shenoy, S., Yevzlin, A. S., Abreo, K., Allon, M., Asif, A., Astor, B. C., Glickman, M. H., Graham, J., Moist, L. M., Rajan, D. K., Roberts, C., Vachharajani, T. J., Valentini, R. P., & National Kidney Foundation. (2020). KDOQI Clinical Practice Guideline for Vascular Access: 2019 update. American Journal of Kidney Diseases, 75(4 Suppl 2), S1–S164. https://doi.org/10.1053/j.ajkd.2019.12.001
Macdougall, I. C., Bock, A. H., Carrera, F., Eckardt, K.-U., Gaillard, C., Van Wyck, D., Roubert, B., Nolen, J. G., & Roger, S. D. (2014). FIND-CKD: A randomized trial of intravenous ferric carboxymaltose versus oral iron in patients with chronic kidney disease and iron deficiency anaemia. Nephrology Dialysis Transplantation, 29(11), 2075–2084. https://doi.org/10.1093/ndt/gfu201
Muñoz Ramos, P., Gil Giraldo, Y., Álvarez Chiva, V., & Quiroga, B. (2021). Effectiveness of biosimilar drugs in the treatment of renal anemia: A case series. Medwave, 21(9), e8474. https://doi.org/10.5867/medwave.2021.09.8474
National Institute for Health and Care Excellence. (2021). Chronic kidney disease: Assessment and management. Overview. https://www.nice.org.uk/guidance/ng203
Portolés, J., Martín, L., Broseta, J. J., & Cases, A. (2021). Anemia in chronic kidney disease: From pathophysiology and current treatments, to future agents. Frontiers in Medicine, 8, 642296. https://doi.org/10.3389/fmed.2021.642296
Souaid, T., Taliercio, J., Simon, J. F., Mehdi, A., & Nakhoul, G. N. (2022). Anemia of chronic kidney disease: Will new agents deliver on their promise? Cleveland Clinic Journal of Medicine, 89(4), 212–222. https://doi.org/10.3949/ccjm.89a.21100
Toblli, J. E., García-García, Á., Aristizábal, A., Quintero, E., Arango, J., Buitrago, C., Gómez, R., Leguizamón, H., Martínez, J., Nieto, I., Osorio, M., Pertuz, A., Restrepo, C., Robayo, A., Rodríguez, K., Rodríguez, R., Romero, J. D., Roselli, C., Torres, R., Villar, J. C., & Amair, P. (2009). Diagnóstico y tratamiento de la anemia en pacientes con enfermedad renal crónica en todos sus estadios. Consenso del Anemia Working Group Latin America (AWGLA). Diálisis y Trasplante, 30(3), 104–108. https://doi.org/10.1016/s1886-2845(09)71938-1
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