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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...

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Autores principales: Wojtaszek, Ewa, Glogowski, Tomasz, Malyszko, Jolanta
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
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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.
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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
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