Inflammation and resistance to erythropoiesis-stimulating agents--what do we know and what needs to be clarified?
Resistance to erythropoiesis-stimulating agents (ESA) in patients with chronic kidney disease (CKD) can be associated with evidence of enhanced systemic inflammatory responses. This review considers the inflammatory mechanisms thought to be involved in the development and aetiology of anaemia of CKD that may help our understanding and management of patients with ESA resistance. The potential role of nutritional support and of anti-inflammatory therapies in managing resistance to ESA therapy is discussed and explored.
Smrzova
Jana
J
Haemodialysis Centre, University Hospital Brno, Brno, Czech Republic.
Balla
Jozsef
J
Bárány
Peter
P
D000740:Anemia / Q000188:drug therapy* / Q000209:etiology; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000975:Antioxidants / Q000627:therapeutic use; D002908:Chronic Disease; D004351:Drug Resistance; D004920:Erythropoiesis / Q000187:drug effects*; D004921:Erythropoietin / Q000627:therapeutic use*; D005293:Ferritins / Q000378:metabolism; D006801:Humans; D007249:Inflammation / Q000150:complications*; D007501:Iron / Q000378:metabolism; D007674:Kidney Diseases / Q000150:complications; D009569:Nitric Oxide / Q000502:physiology; D018529:Nutritional Support; D017382:Reactive Oxygen Species; D011994:Recombinant Proteins
D000893:Anti-Inflammatory Agents; D000975:Antioxidants; D017382:Reactive Oxygen Species; D011994:Recombinant Proteins; D004921:Erythropoietin; D009569:Nitric Oxide; D005293:Ferritins; D007501:Iron