Abstract:
:Red cell production in chronic kidney disease is usually too low to maintain a normal haemoglobin, and thus anaemia develops in a large proportion of patients. The ability to stimulate erythropoiesis in the bone marrow by the use of therapeutic agents has only been possible in the last 20 years, initially with recombinant human erythropoietin (epoetin), and later darbepoetin alfa. Many new agents are, however, in clinical development, and these include CERA, Hematide, and HIF stabilisers, in addition to the imminent launch of biosimilar epoetins. The main issue with biosimilars is the unknown risk of immunogenicity. CERA is a large molecule, approximately twice the size of epoetin, which was created by integrating a single polymer chain into the erythropoietin molecule. CERA has a much prolonged half-life, and Phase II and III clinical trials have investigated administration of CERA every 3 or 4 weeks. Hematide is derived from original research on the erythropoietin-mimetic peptides, and is in Phase II of its clinical trial programme. Again, this compound is being investigated as a once-monthly administration. The HIF stabilizers are orally-active inhibitors of the enzyme that degrades hypoxia-inducible factor (prolyl hydroxylase), and this leads to upregulation of erythropoietin gene expression. Other strategies for stimulating erythropoiesis, briefly described in this review, are at an earlier stage of development. This is an exciting and rapidly developing area of scientific and translational research.
journal_name
Semin Nephroljournal_title
Seminars in nephrologyauthors
Macdougall ICdoi
10.1016/j.semnephrol.2006.05.008subject
Has Abstractpub_date
2006-07-01 00:00:00pages
313-8issue
4eissn
0270-9295issn
1558-4488pii
S0270-9295(06)00074-Xjournal_volume
26pub_type
杂志文章,评审abstract::Studies in patients on maintenance hemodialysis have disclosed a high prevalence of sleeping disorders, which have been linked to various factors including blood urea levels, creatinine levels, parathyroid hormone levels, anemia, systolic and diastolic blood pressure, quality of life, disease intrusiveness, and comorb...
journal_title:Seminars in nephrology
pub_type: 杂志文章
doi:10.1016/j.semnephrol.2005.06.014
更新日期:2006-01-01 00:00:00
abstract::Mineralocorticoid hypertension is hypertension associated with the presence of hypokalemia, metabolic alkalosis, and suppression of plasma renin. Mineralocorticoid hypertension represents only 10% of patients with essential hypertension. However, its recognition is important because it is a potentially reversible caus...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1016/j.semnephrol.2006.10.004
更新日期:2006-11-01 00:00:00
abstract::Frailty is a distinct phenotype that is highly prevalent in chronic kidney disease (CKD) and appears to be more prevalent with decreasing glomerular filtration rate. Exercise training or intervention to increase physical activity may ameliorate poor physical functioning and frailty, and even may improve survival in pa...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1016/j.semnephrol.2016.12.006
更新日期:2017-03-01 00:00:00
abstract::The mortality of end-stage renal disease (ESRD) patients, including those receiving long-term peritoneal dialysis (PD), has remained unacceptably high owing to the prevalence of cardiovascular disease. It is well recognized that both traditional Framingham risk factors and kidney disease-related risk factors may contr...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1016/j.semnephrol.2011.01.005
更新日期:2011-03-01 00:00:00
abstract::Thrombotic microangiopathy represents the clinical picture of thrombocytopenia and hemolytic anemia in the setting of small blood vessel thrombosis, accompanied by varying degrees of organ dysfunction. Well known to both nephrologists and hematologists alike, among the most common and best-studied thrombotic microangi...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1016/j.semnephrol.2012.02.007
更新日期:2012-03-01 00:00:00
abstract::The intravascular volume consists of 40% to 45% red cells. Their production is controlled predominantly by erythropoietin (EPO), a hormone that is secreted particularly when tissue hypoxia is present. Because of this high percentage of the total intravascular volume the question comes to mind that, in addition to hypo...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1016/j.semnephrol.2005.05.007
更新日期:2005-11-01 00:00:00
abstract::Acute kidney injury (AKI) is common in the setting of shock. Hemodynamic instability is a risk factor for the development of AKI, and pathophysiological mechanisms include loss of renal perfusion pressure and impaired microcirculation. Although restoration of mean arterial pressure (MAP) may mitigate the risk of AKI t...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1016/j.semnephrol.2019.06.006
更新日期:2019-09-01 00:00:00
abstract::Cardiovascular disease (CVD) is the major cause of morbidity and mortality in patients with renal failure. Patients with chronic kidney disease have significant CVD, and carry a high cardiovascular burden by the time they commence renal replacement therapy (RRT). The severity of CVD that has been observed in dialysis ...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1053/snep.2002.35964
更新日期:2002-11-01 00:00:00
abstract::The renal tubular epithelium maintains different sets of transport proteins in plasma membrane domains facing the lumenal and mucosal fluids and limits diffusion between these two compartments. This asymmetry is generated by directing transporters to the appropriate membrane domain, a process that requires both an int...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:
更新日期:1998-03-01 00:00:00
abstract::It has been known for decades that urinary potassium excretion varies with a circadian pattern. In this review, we consider the historical evidence for this phenomenon and present an overview of recent developments in the field. Extensive evidence from the latter part of the past century clearly shows that circadian p...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1016/j.semnephrol.2013.04.003
更新日期:2013-05-01 00:00:00
abstract::Membranous nephropathy (MN), the most common cause of adult-onset nephrotic syndrome (NS) in Caucasians, is associated commonly with the secondary complications of hyperlipidemia and hypercoagulability. These may increase the risk for cardiovascular disease, alter the rate of progression of renal disease, and raise th...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1016/s0270-9295(03)00058-5
更新日期:2003-07-01 00:00:00
abstract::Blood pressure increases with age in all US population groups that have been studies, but does so faster in African Americans. Evidence from extensive microscopic renal vascular studies at autopsy supports the view that blood pressure increases with age because of progressive fibroplasia of renal interlobular arteries...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:
更新日期:1996-03-01 00:00:00
abstract::Pancreas transplantation is being performed with increasing frequency and increasing technical success. The availability of new immunosuppressant agents has been associated with a reduction in the previously high rates of allograft rejection in recipients of simultaneous pancreas-kidney transplants. These lower reject...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:
更新日期:2000-03-01 00:00:00
abstract::The rapid understanding of the cellular and molecular basis of organ function and disease processes will be translated in the next millennium into new therapeutic approaches to a wide range of clinical disorders, including acute and chronic renal failure. Central to these new therapies are the developing fields of gen...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:
更新日期:2000-01-01 00:00:00
abstract::The human nuclear genome consists of approximately 3 billion nucleotides. Human beings are 99% similar in DNA sequence to each other, but natural genetic variation in approximately 1% of the DNA sequence is responsible for interindividual differences, including determining who will develop disease and who will remain ...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1016/j.semnephrol.2007.01.003
更新日期:2007-03-01 00:00:00
abstract::The identification of natriuretic peptides as key regulators of natriuresis and vasodilatation, and the appreciation that their secretion is under the control of cardiac hemodynamic and neurohumoral factors, has caused wide interest. The natriuretic peptides are structurally similar, but genetically distinct peptides ...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1053/snep.2002.35666
更新日期:2002-09-01 00:00:00
abstract::Membranous nephropathy remains the most common cause of the nephrotic syndrome in adults. Most patients do well with long-term natural history studies reporting a 10-year renal survival of 70% to 90% but the remainder progress to end stage renal failure. This plus the associated morbidity of those with persistent high...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:
更新日期:2000-05-01 00:00:00
abstract::The importance of hypertension as a cardiovascular risk factor increases progressively with aging, but diastolic blood pressure plateaus at age 50, which leads to a rise in pulse pressure in the elderly. Thus, isolated systolic hypertension with a widened pulse pressure is the most common type of hypertension seen in ...
journal_title:Seminars in nephrology
pub_type: 杂志文章
doi:
更新日期:2002-01-01 00:00:00
abstract::Acute kidney injury (AKI) represents a common and devastating problem in clinical medicine. A major reason is the lack of early biomarkers for AKI, and hence an unacceptable delay in initiating therapy. Fortunately, the application of innovative technologies has uncovered several novel biomarkers. The most promising o...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1016/j.semnephrol.2008.05.010
更新日期:2008-09-01 00:00:00
abstract::Toxic nephropathies cause acute and chronic renal failure, primarily as a result of injury to renal tubular epithelium. There is a well-known capacity in the renal nephron for the synchronous occurrence of both apoptosis and necrosis in toxic nephropathies. This has engendered interest in the differing or complementar...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1016/s0270-9295(03)00085-8
更新日期:2003-09-01 00:00:00
abstract::Small lipids such as eicosanoids exert diverse and complex functions. In addition to their role in regulating normal kidney function, these lipids also play important roles in the pathogenesis of kidney diseases. Increased glomerular cyclooxygenase (COX)1 or COX2 expression has been reported in patients with nephritis...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1016/j.semnephrol.2007.02.008
更新日期:2007-05-01 00:00:00
abstract::The antiphospholipid syndrome (APS) is a systemic autoimmune disorder characterized by a combination of arterial and/or venous thrombosis, pregnancy morbidity, and the persistent presence of circulating antiphospholipid antibodies (aPL). APS has been described as primary APS when it occurs in the absence of any featur...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1016/j.semnephrol.2015.08.009
更新日期:2015-09-01 00:00:00
abstract::Despite intensive research over the past three decades, the events leading to pathogenic autoantibody production and immune deposit formation in individuals with systemic lupus erythematosus continues to be debated. The controversy is fueled by the clinical observations that individual patients with lupus have variabl...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:
更新日期:1999-01-01 00:00:00
abstract::The very limited ability of adult podocytes to proliferate in vivo is clinically significant because podocytes form a vascular barrier that is functionally critical to the nephron, podocyte hypoplasia is a characteristic of disease, and inadequate regeneration of podocytes is a major cause of persistent podocyte hypop...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1016/j.semnephrol.2014.06.008
更新日期:2014-07-01 00:00:00
abstract::Compelling evidence points to a role for IgA receptors in the pathogenesis of IgA nephropathy. The soluble form of the type I IgA receptor (FcalphaRI or CD89) forms complexes with IgA that can be found in patients' serum and that initiate the disease in CD89 transgenic mice. A nonclassic IgA receptor, identified as th...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1016/j.semnephrol.2007.10.010
更新日期:2008-01-01 00:00:00
abstract::Although evidence has accumulated indicating a close relationship between inflammation and atherosclerosis, the relationship between inflammation and vascular calcification in patients with chronic renal failure is unclear. In the present study, the relationship between C-reactive protein (CRP) and vascular calcificat...
journal_title:Seminars in nephrology
pub_type: 杂志文章
doi:10.1016/j.semnephrol.2004.06.008
更新日期:2004-09-01 00:00:00
abstract::Exposure is a critically important aspect to consider in the study and management of drug-induced kidney injury. Although blood concentrations of kidney toxicants often may provide a valid surrogate measure of kidney exposure, the kidney has several unique physiological and biochemical properties that lend themselves ...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1016/j.semnephrol.2018.12.006
更新日期:2019-03-01 00:00:00
abstract::The incidence of progressive kidney disease associated with diabetes continues to increase worldwide. Only partial renoprotection is achieved by current standard therapy with angiotensin-converting enzyme inhibitors and/or angiotensin-receptor blockers, increasing the need for novel therapeutic approaches. Experimenta...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1016/j.semnephrol.2015.03.003
更新日期:2015-03-01 00:00:00
abstract::Congenital anomalies of the kidney and urinary tract anatomy (CAKUT) are common in children and represent approximately 30% of all prenatally diagnosed malformations. CAKUT is phenotypically variable and can affect the kidney(s) alone and/or the lower urinary tract. The spectrum includes more common anomalies such as ...
journal_title:Seminars in nephrology
pub_type: 杂志文章
doi:10.1016/j.semnephrol.2010.06.004
更新日期:2010-07-01 00:00:00
abstract::The association between increased uric acid (UA) levels and cardiovascular disease (CVD) has been observed and studied for many decades. The value of UA as an independent factor within the metabolic risk profile for prediction of CVD in the normal population remains an issue of ongoing discussion. In turn, increasing ...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1016/j.semnephrol.2011.08.007
更新日期:2011-09-01 00:00:00