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Citation
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HERO ID
524858
Reference Type
Journal Article
Title
New alternatives for erythropoietin therapy in chronic renal failure
Author(s)
Stoian, I; Manolescu, B; Atanasiu, V; Lupescu, O
Year
2007
Is Peer Reviewed?
Yes
Journal
Central European Journal of Medicine
ISSN:
1895-1058
EISSN:
1644-3640
Volume
2
Issue
4
Page Numbers
361-378
Language
English
DOI
10.2478/s11536-007-0038-y
Abstract
Erythropoietin (EPO) is one of the main cytokines involved in the regulation of erythropoiesis. The main site of EPO production are the kidneys. An altered EPO production leads to pathological conditions such as anemia and polycythaemia. Due to the progressive loss of renal peritubular cells, patients with chronic kidney disease (CKD) have low EPO plasma levels. This decreases erythron stimulation with the direct consequence of developing anemia. Before the introduction in the clinical practice of rHuEpo, in the late 1980s, the only solution for treating this type of anemia were blood transfusions and anabolic steroids. Even rHuEpo has proven to be safe and effective for treatment of anemias, there are some concerns about its cost, the need for frequent parenteral administration, and development of anti-EPO antibodies. These inconveniences prompted the search for novel erythropoiesis stimulating agents. Different strategies lead to isolation or chemical synthesis of such agents as darbepoetin alfa and EPO mimetics. In this review, we present some general aspects of EPO biology, with emphasis on chronic renal failure, and expose some of the alternatives to EPO used for anemia correction. (C) Versita Warsaw and Springer-Verlag Berlin Heidelberg. All rights reserved.
Keywords
erythropoietin; darbepoetin; hematide; synthetic erythropoiesis; protein; chronic kidney disease; hepcidin; recombinant-human-erythropoietin; chronic kidney-disease; hypoxia-inducible factor-1; dialysis patients; in-vivo; epoetin-alpha; gene-therapy; structural-characterization; hemodialysis-patients; hepcidin expression
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