Format

Send to

Choose Destination
Am J Physiol Renal Physiol. 2013 Nov 1;305(9):F1239-48. doi: 10.1152/ajprenal.00233.2013. Epub 2013 Jul 24.

Renal anemia: from incurable to curable.

Author information

1
54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan. motoy@kuhp.kyoto-u.ac.jp.

Abstract

Renal anemia has been recognized as a characteristic complication of chronic kidney disease. Although many factors are involved in renal anemia, the predominant cause of renal anemia is a relative deficiency in erythropoietin (EPO) production. To date, exogenous recombinant human (rh)EPO has been widely used as a powerful drug for the treatment of patients with renal anemia. Despite its clinical effectiveness, a potential risk for increased mortality has been suggested in patients who receive rhEPO, in addition to the economic burden of rhEPO administration. The induction of endogenous EPO is another therapeutic approach that might have advantages over rhEPO administration. However, the physiological and pathophysiological regulation of EPO are not fully understood, and this lack of understanding has hindered the development of an endogenous EPO inducer. In this review, we will discuss the current treatment for renal anemia and its drawbacks, provide an overview of EPO regulation in healthy and diseased conditions, and propose future directions for therapeutic trials that more directly target the underlying pathophysiology of renal anemia.

KEYWORDS:

erythropoietin; hypoxia-inducible factors; myofibroblast; neural crest; renal anemia

PMID:
23884144
DOI:
10.1152/ajprenal.00233.2013
[Indexed for MEDLINE]
Free full text

Supplemental Content

Full text links

Icon for Atypon
Loading ...
Support Center