Is HIF-PHI the Answer to Tackle ESA Hyporesponsiveness in the Elderly?
Anemia in chronic kidney disease (CKD) has become an important clinical issue with the increased prevalence of elderly patients living with CKD progressing to kidney failure. The causes of anemia in elderly individuals tend to be multifactorial, exacerbated by the physiological effects of aging, fra...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-08-01
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| Series: | Kidney and Dialysis |
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| Online Access: | https://www.mdpi.com/2673-8236/2/3/40 |
| _version_ | 1797464845814071296 |
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| author | Henry H. L. Wu Rajkumar Chinnadurai Robert J. Walker |
| author_facet | Henry H. L. Wu Rajkumar Chinnadurai Robert J. Walker |
| author_sort | Henry H. L. Wu |
| collection | DOAJ |
| description | Anemia in chronic kidney disease (CKD) has become an important clinical issue with the increased prevalence of elderly patients living with CKD progressing to kidney failure. The causes of anemia in elderly individuals tend to be multifactorial, exacerbated by the physiological effects of aging, frailty and declining kidney function. Erythropoiesis-stimulating agents (ESAs) are the conventional therapeutic option for anemia in CKD. However, ESA hyporesponsiveness is a commonly observed issue in clinical practice and an issue that is more challenging to resolve in elderly patients living with frailty, kidney disease, and multi-morbidities. Following the emergence of oral hypoxia-induced factor prolyl-hydroxylase inhibitors (HIF-PHI) in recent years, there is discussion on whether it is a solution to the conundrum of ESA hyporesponsiveness, as HIF-PHI treats anemia via an alternative physiological pathway. There remains uncertainty on the suitability of HIF-PHI use in elderly patients, given a lack of data on its safety over long-term follow-up for the elderly population. Further study is needed to provide answers, considering the clinical significance of this issue within a public-health scale. |
| first_indexed | 2024-03-09T18:13:57Z |
| format | Article |
| id | doaj.art-92648664b6084e7b80c1571603722512 |
| institution | Directory Open Access Journal |
| issn | 2673-8236 |
| language | English |
| last_indexed | 2024-03-09T18:13:57Z |
| publishDate | 2022-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Kidney and Dialysis |
| spelling | doaj.art-92648664b6084e7b80c15716037225122023-11-24T08:55:02ZengMDPI AGKidney and Dialysis2673-82362022-08-012344645310.3390/kidneydial2030040Is HIF-PHI the Answer to Tackle ESA Hyporesponsiveness in the Elderly?Henry H. L. Wu0Rajkumar Chinnadurai1Robert J. Walker2Renal Research Laboratory, Kolling Institute of Medical Research, Royal North Shore Hospital, The University of Sydney, St. Leonards, NSW 2065, AustraliaDepartment of Renal Medicine, Northern Care Alliance NHS Foundation Trust, Salford M6 8HD, UKDepartment of Medicine, University of Otago (Dunedin Campus), Central Dunedin, Dunedin 9016, New ZealandAnemia in chronic kidney disease (CKD) has become an important clinical issue with the increased prevalence of elderly patients living with CKD progressing to kidney failure. The causes of anemia in elderly individuals tend to be multifactorial, exacerbated by the physiological effects of aging, frailty and declining kidney function. Erythropoiesis-stimulating agents (ESAs) are the conventional therapeutic option for anemia in CKD. However, ESA hyporesponsiveness is a commonly observed issue in clinical practice and an issue that is more challenging to resolve in elderly patients living with frailty, kidney disease, and multi-morbidities. Following the emergence of oral hypoxia-induced factor prolyl-hydroxylase inhibitors (HIF-PHI) in recent years, there is discussion on whether it is a solution to the conundrum of ESA hyporesponsiveness, as HIF-PHI treats anemia via an alternative physiological pathway. There remains uncertainty on the suitability of HIF-PHI use in elderly patients, given a lack of data on its safety over long-term follow-up for the elderly population. Further study is needed to provide answers, considering the clinical significance of this issue within a public-health scale.https://www.mdpi.com/2673-8236/2/3/40HIF-PHIESA hyporesponsivenessanemiachronic kidney diseaseagingmulti-morbidities |
| spellingShingle | Henry H. L. Wu Rajkumar Chinnadurai Robert J. Walker Is HIF-PHI the Answer to Tackle ESA Hyporesponsiveness in the Elderly? Kidney and Dialysis HIF-PHI ESA hyporesponsiveness anemia chronic kidney disease aging multi-morbidities |
| title | Is HIF-PHI the Answer to Tackle ESA Hyporesponsiveness in the Elderly? |
| title_full | Is HIF-PHI the Answer to Tackle ESA Hyporesponsiveness in the Elderly? |
| title_fullStr | Is HIF-PHI the Answer to Tackle ESA Hyporesponsiveness in the Elderly? |
| title_full_unstemmed | Is HIF-PHI the Answer to Tackle ESA Hyporesponsiveness in the Elderly? |
| title_short | Is HIF-PHI the Answer to Tackle ESA Hyporesponsiveness in the Elderly? |
| title_sort | is hif phi the answer to tackle esa hyporesponsiveness in the elderly |
| topic | HIF-PHI ESA hyporesponsiveness anemia chronic kidney disease aging multi-morbidities |
| url | https://www.mdpi.com/2673-8236/2/3/40 |
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