中国血液净化

中国血液净化 ›› 2020, Vol. 19 ›› Issue (03): 149-152.doi: 10.3969/j.issn.1671-4091.2020.03.002

• 贫血专题 • 上一篇    下一篇

慢性肾脏病患者的炎症状态及其对肾性贫血治疗的影响

赵璐1,刘虹1   

  1. 1中南大学湘雅二医院肾内科湖南省肾脏病与血液净化重点实验室
  • 收稿日期:2019-12-10 修回日期:2019-12-25 出版日期:2020-03-12 发布日期:2020-03-12
  • 通讯作者: 刘虹 liuhong618@csu.edu.cn E-mail:liuhong618@csu.edu.cn

Inflammatory status and its impact on renal anemia treatment in chronic kidney disease patients

  1. 1Department of Nephrology, The Second Xiangya Hospital of Central South University, Hunan Key Laboratory of Kidney Disease and Blood Purification, Changsha 410011, China
  • Received:2019-12-10 Revised:2019-12-25 Online:2020-03-12 Published:2020-03-12

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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，CKD 患者常伴有慢性炎症状态，炎症可通过抑制红系细胞产生和红细胞生成素(erythropoietin，EPO)的活性，干扰铁稳态等多种途径加重肾性贫血。此时传统治疗方法具有局限性。低氧诱导因子(hypoxia-inducible factors，HIF)在炎症调控过程中具有重要作用，低氧诱导因子-脯氨酰羟化酶抑制剂(hypoxia-inducible factors-prolyl hydroxylase inhibition，HIF-PHI)可通过改善骨髓微环境，促进EPO 生成，下调铁调素表达并加强铁的吸收利用，减轻肾脏炎症损伤，改善CKD 贫血。本文总结了炎症状态对CKD 贫血的影响机制以及相关的治疗进展。

关键词: 贫血, 慢性肾脏病, 炎症, 低氧诱导因子, 低氧诱导因子-脯氨酰羟化酶抑制剂

Abstract:

【Abstract】Renal anemia is a common complication of chronic kidney disease (CKD). CKD patients often complicate with chronic inflammatory status, which can aggravate the renal anemia by interfering with the production of erythrocytes, reactivity to erythropoietin (EPO) and iron homeostasis. Traditional therapies have limited effects on renal anemia. Hypoxia-inducible factor (HIF) plays an important role in the regulation of inflammatory status. Hypoxia-inducible factors-prolyl hydroxylase inhibitor (HIF-PHI) can improve bone marrow microenvironment, leading to the promotion of EPO production, inhibition of hepcidin expression, increase of iron absorption and utilization, and alleviation of inflammatory injury to kidney and renal anemia. In this review, we summarize the recent progress in the mechanism of inflammatory status on anemia and its treatment in CKD patients.

Key words: Anemia, Chronic kidney disease, Inflammation, Hypoxia-inducible factor, Hypoxia-inducible factors-prolyl hydroxylase inhibitor

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