中国血液净化

中国血液净化 ›› 2022, Vol. 21 ›› Issue (01): 1-5.doi: 10.3969/j.issn.1671-4091.2022.01.001

• 专题讲座 •    下一篇

红细胞生成刺激剂对慢性肾脏病患者血压影响的研究进展

赵玉超1,赵慧萍1,左力1   

  1. 1北京大学人民医院肾内科
  • 收稿日期:2021-08-13 修回日期:2021-08-24 出版日期:2022-01-12 发布日期:2022-01-04
  • 通讯作者: 赵慧萍 huipingzhao2009@163.com E-mail:huipingzhao2009@163.com

Research progress in the effect of erythropoiesis stimulants on blood pressure in patients with chronic kidney disease 

  1. 1Department of Nephrology, Peking University People’s Hospital, Beijing 100044, China
  • Received:2021-08-13 Revised:2021-08-24 Online:2022-01-12 Published:2022-01-04

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摘要： 【摘要】肾性贫血是慢性肾脏病(chronic kidney disease,CKD)的常见并发症，与CKD 患者的不良预后相关。肾脏病变导致红细胞生成素(erythropoietin,EPO)不足及铁缺乏是CKD 患者发生贫血的主要原因，红细胞生成刺激剂(erythropoiesis-stimulating agents,ESA)是肾性贫血最重要的治疗药物。当前应用最广泛的是第一代ESA-重组人类红细胞生成素(rHuEPO)。高血压是rHuEPO 最常见的不良反
应，约1/3 接受EPO 治疗的患者会出现血压升高。低氧诱导因子-脯氨酰羟化酶抑制剂(hypoxia inducible factor prolyl hydroxylase inhibitor, HIF-PHI)作为一种新型的ESA，模拟在低氧环境下启动低氧诱导因子(hypoxia inducible factor,HIF)通路，通过抑制HIF 的羟化降解，使HIF 保持稳定，从而有效地治疗肾性贫血，但其对于CKD 患者血压的影响尚无定论。本文将对不同ESA 在治疗肾性贫血时对CKD 患者血压影响的研究进展做一综述。

关键词: 肾性贫血, 红细胞生成刺激剂, 低氧诱导因子, 高血压, 罗沙司他

Abstract: 【Abstract】Renal anemia, a common complication relating to the poor prognosis, is mainly caused by erythropoietin (EPO) deficiency and iron deficiency in chronic kidney disease (CKD) patients. The most important medication to treat renal anemia is the erythropoiesis-stimulating agents (ESA), among which the firstgeneration ESA of recombinant human erythropoietin (rHuEPO) is widely used currently. The most common adverse reaction of rHuEPO is hypertension, accounting for about one third of the patients using rHuEPO. Hypoxia inducible factor prolyl hydroxylase inhibitor (HIF-PHI), a new type of ESA, mimics the activation of
hypoxia inducible factor (HIF) pathway under hypoxic environment through inhibition of hydroxylation and degradation of HIF and maintenance of HIF level to treat renal anemia. This paper reviews the research progress in the effect of ESAs on blood pressure during the treatment of renal anemia in CKD patients.

Key words: Renal anemia, Erythropoiesis-stimulating agents, Hypoxia inducible factor, Hypertension, Roxadustat

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