Journal
THERAPEUTIC APHERESIS AND DIALYSIS
Volume 22, Issue 3, Pages 242-245Publisher
WILEY
DOI: 10.1111/1744-9987.12685
Keywords
Anemia; Erythropoietin; Fibroblast growth factor 23; Parathyroid hormone; Secondary hyperparathyroidism
Categories
Funding
- Ono Pharmaceutical
- Bayer Yakuhin
- Chugai Pharmaceutical
- Kyowa Hakko Kirin
- Astellas Pharma
- EA Pharma
- Torii Pharmaceutical
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Anemia is a common complication of chronic kidney disease (CKD). There are various causes of renal anemia such as decreased production of erythropoietin, resistance to erythropoietin, shortened survival of red blood cells, and bone marrow fibrosis. Secondary hyperparathyroidism (SHPT) is a less recognized, but potentially significant cause of renal anemia in CKD patients. Parathyroid hormone (PTH) has been regarded as a uremic toxin that has multiple adverse effects, and its elevated levels have been associated with renal anemia in hemodialysis patients. Moreover, recent clinical studies have shown that the treatment of SHPT using either vitamin D receptor activators, calcimimetics, or parathyroidectomy leads to improvement of anemia, supporting the role of PTH in renal anemia. Emerging data have also indicated the involvement of bone-derived fibroblast growth factor 23 in renal anemia. This review summarizes recent insights into the role of PTH in renal anemia and discusses the importance of treating SHPT in improving the control of renal anemia in hemodialysis patients.
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