Impact of Hemodialysis Therapy on Anemia of Chronic Kidney Disease: The Potential Mechanisms

被引:38
作者
Bowry, Sudhir K. [1 ]
Gatti, Emanuele [2 ]
机构
[1] Fresenius Med Care, Sci Affairs, DE-61352 Bad Homburg, Germany
[2] Univ Krems, Ctr Biomed Technol Danube, Krems, Austria
关键词
Online hemodiafiltration; Anemia of chronic kidney disease; Uremic toxins; PATIENTS RECEIVING HEMODIAFILTRATION; ONLINE HEMODIAFILTRATION; ERYTHROPOIETIN RESISTANCE; CHRONIC INFLAMMATION; ULTRAPURE DIALYSATE; INTRAVENOUS IRON; MORTALITY RISK; CFU-E; HEMOGLOBIN; MANAGEMENT;
D O I
10.1159/000329573
中图分类号
R5 [内科学];
学科分类号
100201 [内科学];
摘要
A significant and increasing number of chronic kidney disease (CKD) patients are treated with online hemodiafiltration (OL-HDF), even in the absence of more conclusive survival data. OL-HDF affords several clinical benefits including control of anemia of CKD, a common affliction in dialysis patients. In efforts to understand the underlying mechanisms that contribute to the purported benefits of OL-HDF, we examined the potential role and impact of OL-HDF on key stages of anemia and its correction: erythropoiesis of bone marrow, circulating erythrocytes and on anemia therapy. We review evidence that indicates OL-HDF may modulate key processes of anemia and its therapy, including underlying conditions and responses of uremic toxicity and inflammation that aggravate anemia. Our assessment indicates that OL-HDF favorably impacts anemia by not only eliminating putative uremic inhibitors that suppress erythropoiesis, reducing red cell destruction and increasing iron availability, but also by mechanisms restricting underlying inflammation and endothelial dysfunction that are crucial to both CKD and anemia. Copyright (C) 2011 S. Karger AG, Basel
引用
收藏
页码:210 / 219
页数:10
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