Cargando…
Iron and Chronic Kidney Disease: Still a Challenge
Anemia is a clinical feature of chronic kidney disease (CKD). Most common causes are iron and erythropoietin deficiency. The last two decades have yielded significant advances in understanding iron balance's physiology, including iron trafficking and the crosstalk between iron, oxygen, and eryt...
Autores principales: | , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2020
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7775475/ https://www.ncbi.nlm.nih.gov/pubmed/33392212 http://dx.doi.org/10.3389/fmed.2020.565135 |
_version_ | 1783630474945495040 |
---|---|
author | Wojtaszek, Ewa Glogowski, Tomasz Malyszko, Jolanta |
author_facet | Wojtaszek, Ewa Glogowski, Tomasz Malyszko, Jolanta |
author_sort | Wojtaszek, Ewa |
collection | PubMed |
description | Anemia is a clinical feature of chronic kidney disease (CKD). Most common causes are iron and erythropoietin deficiency. The last two decades have yielded significant advances in understanding iron balance's physiology, including iron trafficking and the crosstalk between iron, oxygen, and erythropoiesis. This knowledge sheds new light on the regulation and disturbance of iron homeostasis in CKD and holds the promise for developing new diagnostic and therapeutic tools to improve the management of iron disorders. Hepcidin–ferroportin axis has a central role in regulating body iron balance and coordinating communication between tissues and cells that acquire, store, and utilize iron. Recent research has revealed a bidirectional relationship between fibroblast growth factor 23 (FGF23) and iron status, anemia, and inflammation, as well as the role of erythroferrone (ERFE) in iron homeostasis. However, ERFE concentrations and actions are not well-characterized in CKD patients. Studies on ERFE in CKD are limited with slightly conflicting results. Despite general interest in iron metabolism in kidney diseases, studies on the less prevalent renal replacement therapy mode, such as peritoneal dialysis or hemodiafiltration, are scarce. Slightly more was published on hemodialysis. There are several novel options on the horizon; however, clinical data are limited. One should be aware of the potential risks and benefits of the novel, sophisticated therapies. An inhibition of hepcidin on the different pathways might be also a viable adjunctive therapeutic option in other clinical situations. |
format | Online Article Text |
id | pubmed-7775475 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-77754752021-01-02 Iron and Chronic Kidney Disease: Still a Challenge Wojtaszek, Ewa Glogowski, Tomasz Malyszko, Jolanta Front Med (Lausanne) Medicine Anemia is a clinical feature of chronic kidney disease (CKD). Most common causes are iron and erythropoietin deficiency. The last two decades have yielded significant advances in understanding iron balance's physiology, including iron trafficking and the crosstalk between iron, oxygen, and erythropoiesis. This knowledge sheds new light on the regulation and disturbance of iron homeostasis in CKD and holds the promise for developing new diagnostic and therapeutic tools to improve the management of iron disorders. Hepcidin–ferroportin axis has a central role in regulating body iron balance and coordinating communication between tissues and cells that acquire, store, and utilize iron. Recent research has revealed a bidirectional relationship between fibroblast growth factor 23 (FGF23) and iron status, anemia, and inflammation, as well as the role of erythroferrone (ERFE) in iron homeostasis. However, ERFE concentrations and actions are not well-characterized in CKD patients. Studies on ERFE in CKD are limited with slightly conflicting results. Despite general interest in iron metabolism in kidney diseases, studies on the less prevalent renal replacement therapy mode, such as peritoneal dialysis or hemodiafiltration, are scarce. Slightly more was published on hemodialysis. There are several novel options on the horizon; however, clinical data are limited. One should be aware of the potential risks and benefits of the novel, sophisticated therapies. An inhibition of hepcidin on the different pathways might be also a viable adjunctive therapeutic option in other clinical situations. Frontiers Media S.A. 2020-12-18 /pmc/articles/PMC7775475/ /pubmed/33392212 http://dx.doi.org/10.3389/fmed.2020.565135 Text en Copyright © 2020 Wojtaszek, Glogowski and Malyszko. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Medicine Wojtaszek, Ewa Glogowski, Tomasz Malyszko, Jolanta Iron and Chronic Kidney Disease: Still a Challenge |
title | Iron and Chronic Kidney Disease: Still a Challenge |
title_full | Iron and Chronic Kidney Disease: Still a Challenge |
title_fullStr | Iron and Chronic Kidney Disease: Still a Challenge |
title_full_unstemmed | Iron and Chronic Kidney Disease: Still a Challenge |
title_short | Iron and Chronic Kidney Disease: Still a Challenge |
title_sort | iron and chronic kidney disease: still a challenge |
topic | Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7775475/ https://www.ncbi.nlm.nih.gov/pubmed/33392212 http://dx.doi.org/10.3389/fmed.2020.565135 |
work_keys_str_mv | AT wojtaszekewa ironandchronickidneydiseasestillachallenge AT glogowskitomasz ironandchronickidneydiseasestillachallenge AT malyszkojolanta ironandchronickidneydiseasestillachallenge |