Diagnosing & treating anemia may help patients with CKD to prevent the decline of their kidneys functions. Anemia might occur early in the development of kidney disease. A new set of medications currently in development, could improve the mobilization of iron and absorption of iron to anemia.
How does anemia affect the kidneys?
When kidneys are healthy, they produce a hormone called erythropoietin ("EPO"). This hormone helps the bone marrow to produce the amount of red blood cells that the body needs to carry oxygen to vital organs such as the heart and brain. When the kidneys are damaged, they sometimes do not make enough EPO. As a result, the bone marrow doesn’t make enough red blood cells.
“Several new classes of agents that are in the drug development pipeline could have a significant impact on changing our approach to anemia in patients with CKD”, said Jay B. Wish, professor of clinical medicine at Indiana University School of Medicine and chief medical officer for dialysis at Indiana University Health.
How is anemia most commonly treated with CKD?
Anemia in people with CKD might be treated with Erythropoiesis Stimulating Agents ("ESAs"). These can be prescribed for patients with CKD when anemia is caused by not having enough EPO in the body. ESAs are usually injected under the skin or given intravenously during hemodialysis.
What is the relationship between anemia and the quality of life in patients with CKD?
For individuals with CKD it might be beneficial to treat anemia considering there could potentially be risks with having low hemoglobin levels. Treating anemia may also ease many of the common symptoms from kidney disease so that you feel better.
Jay B. Wish said in a video, "it’s one thing to say that low hemoglobin levels are associated with poor quality of life, especially on the physical side. It’s another thing to say that treatment of that anemia necessarily improves quality of life". According to Jay B. Wish, we have previously lost the opportunity to convincingly demonstrate whether it affects the quality of life. However, he said, we have another chance with these stabilizers that are currently in development.
What is the new set of medications?
The most prominent set of drugs includes hypoxy inducible factor stabilizer ("HIF").
How does this drug development affect patients with CKD?
“The class of drugs is used to prevent the degradation of HIF, which leads to the transcription of a number of genes that are related to erythropoiesis, a number of iron-handling proteins that improve iron absorption and release or iron from internal stores in the reticuloendothelial system” stated Jay B. Wish.
In another video, Jay B. Wish said, “it is hoped that this will lead to a decrease in some of those adverse cardiovascular endpoints that have been seen in patients receiving large doses of exogenous erythropoietin-stimulating agents".
In conclusion, Jay B. Wish said “this will probably lead to much better compliance and also better mobilization of iron and absorption of iron so you won’t necessarily see the kinds of iron deficiency states with this newer class of drugs that you generally see with ESAs".