HIF-PHIs for Renal Anemia in Patients With NDD-CKD

Management of renal anemia, a common complication of chronic kidney disease (CKD), has traditionally included injectable erythropoietin-stimulating agents (ESAs). However, concerns regarding the cardiovascular safety of ESAs among patients with CKD, as well as emerging erythropoietin resistance, have created a need for alternative therapies.

The oral agent hypoxia-inducible factor prolyl hydroxylase inhibitor (HIF-PHI) has been shown to be effective in improving renal anemia. However, according to Hanxue Zhao, MD, and colleagues in China, the effects of HIF-PHIs among patients with nondialysis-dependent CKD (NDD-CKD) have yet to be supported by updated meta-analysis.

The researchers conduced a systemic search and meta-analysis of clinical randomized controlled trials among patients with NDD-CKD treated with HIF-PHIs. The search included PubMed, EMBASE, and Cochrane databases through July 16, 2023. The primary outcomes of interest were hemoglobin levels postintervention and the ratio of hemoglobin responses.

A total of 22 studies were included in the meta-analysis. The study cohorts included 7178 participants in the HIF-PHI group, 3501 in the ESA group, and 2533 in the placebo group. The results suggested that treatment with HIF-PHIs increased the level of hemoglobin and improved iron metabolism. HIF-PHIs were not inferior to ESAs in terms of safety.

“HIF-PHIs may be a convenient and safe alternative to ESAs in patients with NDD-CKD and anemia,” the researchers said.

Source:   Renal Failure