Controversies in optimal anemia management: conclusions from a Kidney Disease: Improving (KDIGO) Conference
Controversies in optimal anemia management: conclusions from a Kidney Disease: Improving (KDIGO) Conference
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DOI：
10.1016/j.kint.2021.03.020
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发表时间：
2021-05-19
影响因子：
19.6
通讯作者：
Drueke, Tilman B.
中科院分区：
文献类型：
--
作者：
Babitt, Jodie L.;Eisenga, Michele F.;Drueke, Tilman B.
在慢性肾脏疾病中，贫血和铁稳态紊乱是普遍存在的，并与显著的不良后果相关。2012年，肾脏病：改善全球结局（KDIGO）发布了一项贫血指南，用于管理慢性肾脏病贫血的诊断，评估和治疗。从那时起，基础研究、流行病学研究和随机试验中积累了新的数据，这些数据需要重新审视以前的建议。因此，在2019年，KDIGO决定召开两次争议会议，以审查最新证据，探索新的和正在进行的争议，评估当前KDIGO贫血指南的变化影响，并提出研究议程。这里描述的第一次会议主要集中在铁相关问题上，包括铁稳态紊乱对慢性肾脏病贫血的贡献，诊断挑战，可用和新兴的铁疗法，治疗目标和患者结局。第二次会议将讨论更具体的红细胞生成刺激剂，包括促红细胞生成素，和缺氧诱导因子脯氨酰羟化酶抑制剂有关的问题。在这里，我们提供了一个简明扼要的共识点和第一次会议产生的争议和优先考虑的关键问题，需要回答未来的研究。
In chronic kidney disease, anemia and disordered iron homeostasis are prevalent and associated with significant adverse consequences. In 2012, Kidney Disease: Improving Global Outcomes (KDIGO) issued an anemia guideline for managing the diagnosis, evaluation, and treatment of anemia in chronic kidney disease. Since then, new data have accrued from basic research, epidemiological studies, and randomized trials that warrant a re-examination of previous recommendations. Therefore, in 2019, KDIGO decided to convene 2 Controversies Conferences to review the latest evidence, explore new and ongoing controversies, assess change implications for the current KDIGO anemia guideline, and propose a research agenda. The first conference, described here, focused mainly on iron-related issues, including the contribution of disordered iron homeostasis to the anemia of chronic kidney disease, diagnostic challenges, available and emerging iron therapies, treatment targets, and patient outcomes. The second conference will discuss issues more specifically related to erythropoiesis-stimulating agents, including epoetins, and hypoxia-inducible factor-prolyl hydroxylase inhibitors. Here we provide a concise overview of the consensus points and controversies resulting from the first conference and prioritize key questions that need to be answered by future research.