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Dialyse aktuell 2021; 25(07): 280-284
DOI: 10.1055/a-1402-8805
Schwerpunkt
Nephrologie

Therapie der renalen Anämie

Erythropoietin, Erythropoese stimulierende Agenzien,Eisen und HIF-Stabilisatoren
Insa E. Emrich
1   Klinik für Innere Medizin III, Klinik für Kardiologie, Angiologie und internistische Intensivmedizin, Universitätsklinikum des Saarlandes, Homburg
,
Michael Böhm
1   Klinik für Innere Medizin III, Klinik für Kardiologie, Angiologie und internistische Intensivmedizin, Universitätsklinikum des Saarlandes, Homburg
,
Gunnar H. Heine
2   Agaplesion Markus Krankenhaus, Medizinische Klinik II, Frankfurt a. M.
3   Universität des Saarlandes, Medizinische Fakultät, Homburg
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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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