Management of Anemia in CKD: A Review

International Journal of Research and Scientific Innovation (IJRSI) | Volume VII, Issue IV, April 2020 | ISSN 2321–2705

Management of Anemia in CKD: A Review

Lubana K V¹, Dr. Linu Mohan P², Asha G³, Fathimath Shahban^{4
1,3, 4}Student, ²Associate Professor
Department of Pharmacy Practice, Al Shifa College of Pharmacy, Kizhattur, Malappuram, Kerala, India

Abstract: Chronic Kidney Disease leads to progressive failure to the kidney. If untreated, a number of complications may arise such as anemia, hyperlipidemia, cardiovascular disease. Renal anemia is highly prevalent in CKD patients (both in dialysis and nondialysis). Anemia can be managed by using either Erythropoietin Stimulating Agent (ESA) or by IV iron therapy. Recombinant human erythropoietin (rHuEPO) is widely used ESA to treat anemia. Hemoglobin (Hb) variation can be controlled by using these agents. The IV iron therapy is also considered a standard care in anemia management because it can reduce the exposure to ESA. Anemia contributes to increases morbidity, mortality and poor quality of life. Treating anemia mainly in dialysis patients with ESA reduces the risk of blood transfusion and increase the patient quality of life. This is because it can cause either hyporesponsivenes or erythropoietin resistance. Another recently discovered drug Roxadustat is a promising therapeutic approach against anemia in CKD. The hemoglobin response of roxadustat is independent of inflammatory microenvironment.

Key words: Chronic kidney disease, anemia, erythropoietin, hemoglobin, erythropoietin resistance, Roxadustat

I. INTRODUCTION

Kidney disease is defined as a heterogeneous group of disorders which affects the kidney structure and function. Duration of less than 3 months is defined as acute and duration of greater than 3 months or is termed as chronic. Chronic kidney disease is a slow and progressive loss of kidney function over a period of several years. Eventually, a person will develop permanent kidney failure. Chronic kidney disease, also known as chronic renal failure, chronic renal disease, or chronic kidney failure. As kidney failure advances and the organ’s function is severely impaired, dangerous levels of waste and fluid can rapidly build up in the body. Treatment is aimed at stopping or slowing down the progression of the disease – this is usually done by controlling its underlying cause. Common symptoms include blood in urine, high blood pressure, and fatigue. Causes include diabetes and specific kidney diseases, which consist of polycystic kidney disease. There is no cure for chronic kidney disease, which means treatment is focused on reducing symptoms. Diagnosis commonly occurs after blood tests, kidney scans, or biopsy. Assessment of CKD severity can be facilitated by using National Kidney Foundation developed criteria, as part of its Kidney Disease Outcomes Quality Initiative [1].

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