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Dialyse aktuell 2021; 25(07): 280-284
DOI: 10.1055/a-1402-8805
DOI: 10.1055/a-1402-8805
Schwerpunkt
Nephrologie
Therapie der renalen Anämie
Erythropoietin, Erythropoese stimulierende Agenzien,Eisen und HIF-Stabilisatoren
ZUSAMMENFASSUNG
Die Einführung von Präparaten mit Erythropoietin (EPO)/Erythropoese stimulierenden Agenzien (ESA) zur Behandlung der renalen Anämie Ende der 1980er-Jahre ermöglichte eine Einsparung von Blutkonserven und eine Verbesserung der Lebensqualität von chronisch nierenkranken und v. a. dialysepflichtigen Patienten. Nach den negativen Ergebnissen der großen EPO/ESA-Endpunktstudien Mitte der 1990er-Jahre, erschien mit PIVOTAL 2019 eine randomisierte Studie zur intravenösen Eisentherapie, die eine prognostische Überlegenheit einer Hochdosiseisentherapie gegenüber einer restriktiveren Eisenapplikation zeigte. Mit den HIF-Stabilisatoren (HIF: Hypoxie induzierbarer Faktor) wird jetzt eine weitere – orale – Behandlungsoption der renalen Anämie verfügbar. Phase-II- und Phase-III-Studien zeigten eine Nichtunterlegenheit im Hinblick auf den Hämoglobinanstieg gegenüber einer Behandlung mit EPO/ESA-Präparaten. Da HIF-Stabilisatoren in die Transkription von unterschiedlichsten Genen eingreifen, müssen Sicherheitsstudien weitere wichtige Erkenntnisse liefern.
Publication History
Article published online:
10 September 2021
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