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Anemia in Chronic Kidney Disease

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Chronic Kidney Disease

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Abstract

Anemia is an important and frequent complication in patients with chronic kidney disease (CKD), and its prevalence increases as renal function declines. The etiology of anemia in CKD is multifactorial, including absolute or relative lack of erythropoietin, iron deficiency, blood loss, shortened red blood cell survival, and other factors. Anemia in CKD is associated with impaired quality of life and elevated morbidity and mortality of cardiovascular diseases. Patients with CKD should monitor hemoglobin levels regularly. If the degree of anemia is not consistent with that of renal dysfunction in patients with CKD, it is necessary to rule out the existence of other diseases that can cause anemia. Erythropoiesis-stimulating agent (ESA) and iron supplementation are the primary treatment for anemia in CKD. Hemoglobin levels and iron status should be monitored regularly during treatment. It is generally recommended that hemoglobin concentration not exceed 115 g/L in patients undergoing ESA maintenance; the monthly hemoglobin growth rate should be limited in ≥10 g/L, but <20 g/L. Transfusions should be avoided as much as possible. Inhibitors of hypoxia-inducible factor prolyl hydroxylase is a kind of new promising therapeutic drugs.

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References

  1. Stauffer ME, Fan T. Prevalence of anemia in chronic kidney disease in the United States. PLoS One. 2014;9:e84943.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  2. Suzuki M, Hada Y, Akaishi M, Hiroe M, Aonuma K, Tsubakihara Y, et al. Effects of anemia correction by erythropoiesis-stimulating agents on cardiovascular function in non-dialysis patients with chronic kidney disease. Int Heart J. 2012;53(4):238–43.

    Article  CAS  PubMed  Google Scholar 

  3. Drüeke TB, Parfrey PS. Summary of the KDIGO guideline on anemia and comment: reading between the guidelines. Kidney Int. 2012;82(9):952–60.

    Article  PubMed  Google Scholar 

  4. Robinson B, Artz AS, Culleton B, Critchlow C, Sciarra A, Audhya P. Prevalence of anemia in the nursing home: contribution of chronic kidney disease. J Am Geriatr Soc. 2007;55:1566–70.

    Article  PubMed  Google Scholar 

  5. Shaheen FA, Souqiyyeh MZ, Al-Attar BA, Karkar A, Al Jazairi AM, Badawi LS, Ballut OM, Hakami AH, Naguib M, Al-Homrany MA, Barhamein MY, Ahmed AM, Khardaji MM, Said SA, Anemia Prevalence in CKD Patients Group. Prevalence of anemia in predialysis chronic kidney disease patients. Saudi J Kidney Dis Transpl. 2011;22(3):456–63.

    PubMed  Google Scholar 

  6. Li Y, Shi H, Wang WM, Peng A, Jiang GR, Zhang JY, et al. Prevalence, awareness, and treatment of anemia in Chinese patients with nondialysis chronic kidney disease: first multicenter, cross-sectional study. Medicine (Baltimore). 2016;95:e3872.

    Article  CAS  Google Scholar 

  7. El-Achkar TM, Ohmit SE, McCullough PA, Flack JM. Higher prevalence of anemia with diabetes mellitus in moderate kidney insufficiency: the Kidney Early Evaluation Program. Kidney Int. 2005;67(4):1483–8.

    Article  PubMed  Google Scholar 

  8. New JP, Aung T, Baker PG, Yongsheng G, Pylypczuk R, Houghton J, et al. The high prevalence of unrecognized anaemia in patients with diabetes and chronic kidney disease: a population based-study. Diabet Med. 2008;25(5):564–9.

    Article  CAS  PubMed  Google Scholar 

  9. Hsu CY, Curhan GC, McCulloch CE. Epidemiology of anemia associated with chronic renal insufficiency among adults in the United States: results from the Third National Health and Nutrition Examination Survey. J Am Soc Nephrol. 2002;13:504–10.

    Article  PubMed  CAS  Google Scholar 

  10. Ble A, Fink JC, Woodman RC, Klausner MA, Windham BG, Guralnik JM, Ferrucci L. Renal function, erythropoietin, and anemia of older persons: the InCHIANTI study. Arch Intern Med. 2005;165(19):2222–7.

    Article  CAS  PubMed  Google Scholar 

  11. Ryu SR, Park SK, Jung JY, Kim YH, Oh YK, Yoo TH, Sung S. The prevalence and management of anemia in chronic kidney disease patients: result from the KoreaN cohort study for outcomes in patients with chronic kidney disease (KNOW-CKD). J Korean Med Sci. 2017;32(2):249–56.

    Article  PubMed  Google Scholar 

  12. Chen L, Ling YS, Lin CH, He JX, Guan TJ. High dose ESAs are associated with high iPTH levels in hemodialysis patients with end-stage kidney disease: a retrospective analysis. Front Public Health. 2015;3:258.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Eschbach JW. The anemia of chronic renal failure: pathophysiology and the effects of recombinant erythropoietin. Kidney Int. 1989;35(1):134–48.

    Article  CAS  PubMed  Google Scholar 

  14. Erslev AJ, Besarab A. The rate and control of baseline red cell production in hematologically stable patients with uremia. J Lab Clin Med. 1995;126(3):283–6.

    CAS  PubMed  Google Scholar 

  15. Maxwell PH, Ferguson DJ, Nicholls LG, Iredale JP, Pugh CW, Johnson MH, Ratcliffe PJ. Sites of erythropoietin production. Kidney Int. 1997;51(2):393–401.

    Article  CAS  PubMed  Google Scholar 

  16. Lin FK, Suggs S, Lin CH, Browne JK, Smalling R, Egrie JC, Chen KK, Fox GM, Martin F, Stabinsky Z, et al. Cloning and expression of the human erythropoietin gene. Proc Natl Acad Sci U S A. 1985;82(22):7580–4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Kapitsinou PP, Liu Q, Unger TL, Rha J, Davidoff O, Keith B, Epstein JA, Moores SL, Erickson-Miller CL, Haase VH. Hepatic HIF-2 regulates erythropoietic responses to hypoxia in renal anemia. Blood. 2010;116(16):3039–48.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Fandrey J. Oxygen-dependent and tissue-specific regulation of erythropoietin gene expression. Am J Physiol Regul Integr Comp Physiol. 2004;286(6):977–88.

    Article  Google Scholar 

  19. Fehr T, Ammann P, Garzoni D, Korte W, Fierz W, Rickli H, Wüthrich RP. Interpretation of erythropoietin levels in patients with various degrees of renal insufficiency and anemia. Kidney Int. 2004;66(3):1206–11.

    Article  CAS  PubMed  Google Scholar 

  20. Radtke HW, Claussner A, Erbes PM, Scheuermann EH, Schoeppe W, Koch KM. Serum erythropoietin concentration in chronic renal failure: relationship to degree of anemia and excretory renal function. Blood. 1979;54(4):877–84.

    Article  CAS  PubMed  Google Scholar 

  21. Costa E, Lima M, Alves JM, Rocha S, Rocha-Pereira P, Castro E, Miranda V, do SF LA, Quintanilha A, Belo L, Santos-Silva A. Inflammation, T-cell phenotype, and inflammatory cytokines in chronic kidney disease patients under hemodialysis and its relationship to resistance to recombinant human erythropoietin therapy. J Clin Immunol. 2008;28(3):268–75.

    Article  CAS  PubMed  Google Scholar 

  22. Pereira R, Costa E, Gonçalves M, Miranda V, do Sameiro Faria M, Quintanilha A, Belo L, Lima M, Santos-Silva A. Neutrophil and monocyte activation in chronic kidney disease patients under hemodialysis and its relationship with resistance to recombinant human erythropoietin and to the hemodialysis procedure. Hemodial Int. 2010;14(3):295–301.

    Article  PubMed  Google Scholar 

  23. Ganz T, Nemeth E. Hepcidin and disorders of iron metabolism. Annu Rev Med. 2011;62:347–60.

    Article  CAS  PubMed  Google Scholar 

  24. Łukaszyk E, Łukaszyk M, Koc-Żórawska E, Tobolczyk J, Bodzenta-Łukaszyk A, Małyszko J. Iron status and inflammation in early stages of chronic kidney disease. Kidney Blood Press Res. 2015;40(4):366–73.

    Article  PubMed  CAS  Google Scholar 

  25. Kushner D, Beckman B, Nguyen L, Chen S, Della Santina C, Husserl F, Rice J, Fisher JW. Polyamines in the anemia of end-stage renal disease. Kidney Int. 1991;39(4):725–32.

    Article  CAS  PubMed  Google Scholar 

  26. Ureña P, Eckardt KU, Sarfati E, Zingraff J, Zins B, Roullet JB, Roland E, Drüeke T, Kurtz A. Serum erythropoietin and erythropoiesis in primary and secondary hyperparathyroidism: effect of parathyroidectomy. Nephron. 1991;59(3):384–93.

    Article  PubMed  Google Scholar 

  27. Drüeke TB, Eckardt KU. Role of secondary hyperparathyroidism in erythropoietin resistance of chronic renal failure patients. Nephrol Dial Transplant. 2002;17(Suppl 5):28–31.

    Article  PubMed  Google Scholar 

  28. Chawla LS, Krishnan M. Causes and consequences of inflammation on anemia management in hemodialysis patients. Hemodial Int. 2009;13(2):222–34.

    Article  PubMed  Google Scholar 

  29. Freedman MH, Saunders EF, Cattran DC, Rabin EZ. Ribonuclease inhibition of erythropoiesis in anemia of uremia. Am J Kidney Dis. 1983;2(5):530–3.

    Article  CAS  PubMed  Google Scholar 

  30. Le Meur Y, Lorgeot V, Comte L, Szelag JC, Aldigier JC, Leroux-Robert C, Praloran V. Plasma levels and metabolism of AcSDKP in patients with chronic renal failure: relationship with erythropoietin requirements. Am J Kidney Dis. 2001;38(3):510–7.

    Article  PubMed  Google Scholar 

  31. Pawlak D, Koda M, Pawlak S, Wolczynski S, Buczko W. Contribution of quinolinic acid in the development of anemia in renal insufficiency. Am J Physiol Renal Physiol. 2003;284(4):F693–700.

    Article  CAS  PubMed  Google Scholar 

  32. Niwa T, Asada H, Tsutsui S, Miyazaki T. Efficient removal of albumin-bound furancarboxylic acid by protein-leaking hemodialysis. Am J Nephrol. 1995;15(6):463–7.

    Article  CAS  PubMed  Google Scholar 

  33. Matsumura M, Hatakeyama S, Koni I, Mabuchi H, Muramoto H. Correlation between serum carnitine levels and erythrocyte osmotic fragility in hemodialysis patients. Nephron. 1996;72(4):574–8.

    Article  CAS  PubMed  Google Scholar 

  34. Nikolaos S, George A, Telemachos T, Maria S, Yannis M, Konstantinos M. Effect of L-carnitine supplementation on red blood cell deformability in hemodialysis patients. Ren Fail. 2000;22(1):73–80.

    Article  CAS  PubMed  Google Scholar 

  35. Arduini A, Rossi M, Mancinelli G, Belfiglio M, Scurti R, Radatti G, Shohet SB. Effect of L-carnitine and acetyl-L-carnitine on the human erythrocyte membrane stability and deformability. Life Sci. 1990;47(26):2395–400.

    Article  CAS  PubMed  Google Scholar 

  36. Altmann P, Plowman D, Marsh F, Cunningham J. Aluminium chelation therapy in dialysis patients: evidence for inhibition of haemoglobin synthesis by low levels of aluminium. Lancet. 1988;1(8593):1012–5.

    Article  CAS  PubMed  Google Scholar 

  37. Wu SG, Jeng FR, Wei SY, Su CZ, Chung TC, Chang WJ, Chang HW. Red blood cell osmotic fragility in chronically hemodialyzed patients. Nephron. 1998;78(1):28–32.

    Article  CAS  PubMed  Google Scholar 

  38. Milner JD, Orekov T, Ward JM, Cheng L, Torres-Velez F, Junttila I, Sun G, Buller M, Morris SC, Finkelman FD, Paul WE. Sustained IL-4 exposure leads to a novel pathway for hemophagocytosis, inflammation, and tissue macrophage accumulation. Blood. 2010;116(14):2476–83.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  39. Vlahakos DV, Marathias KP, Kosmas EN. Losartan reduces hematocrit in patients with chronic obstructive pulmonary disease and secondary erythrocytosis. Ann Intern Med. 2001;134(5):426–7.

    Article  CAS  PubMed  Google Scholar 

  40. Hirase N, Yanase T, Mu Y, Muta K, Umemura T, Takayanagi R, Nawata H. Thiazolidinedione suppresses the expression of erythroid phenotype in erythroleukemia cell line K562. Leuk Res. 2000;24(5):393–400.

    Article  CAS  PubMed  Google Scholar 

  41. Berria R, Gastaldelli A, Lucidi S, Belfort R, De Filippis E, Easton C, Brytzki R, Cusi K, Jovanovic L, DeFronzo R. Reduction in hematocrit level after pioglitazone treatment is correlated with decreased plasma free testosterone level, not hemodilution, in women with polycystic ovary syndrome. Clin Pharmacol Ther. 2006;80(2):105–14.

    Article  CAS  PubMed  Google Scholar 

  42. Bermudez V, Finol F, Parra N, Parra M, Pérez A, Peñaranda L, Vílchez D, Rojas J, Arráiz N, Velasco M. PPAR-gamma agonists and their role in type 2 diabetes mellitus management. Am J Ther. 2010;17(3):274–83.

    Article  PubMed  Google Scholar 

  43. Eckardt KU, Kurtz A, Bauer C. Regulation of erythropoietin production is related to proximal tubular function. Am J Phys. 1989;256(5 Pt 2):942–7.

    Google Scholar 

  44. Bakris GL, Sauter ER, Hussey JL, Fisher JW, Gaber AO, Winsett R. Effects of theophylline on erythropoietin production in normal subjects and in patients with erythrocytosis after renal transplantation. N Engl J Med. 1990;323(2):86–90.

    Article  CAS  PubMed  Google Scholar 

  45. Weiner DE, Tighiouart H, Vlagopoulos PT, Griffith JL, Salem DN, Levey AS, Sarnak MJ. Effects of anemia and left ventricular hypertrophy on cardiovascular disease in patients with chronic kidney disease. J Am Soc Nephrol. 2005;16(6):1803–10.

    Article  PubMed  Google Scholar 

  46. Klinger M, Arias M, Vargemezis V, Besarab A, Sulowicz W, Gerntholtz T, Ciechanowski K, Dougherty FC, Beyer U. Efficacy of intravenous methoxy polyethylene glycol-epoetin beta administered every 2 weeks compared with epoetin administered 3 times weekly in patients treated by hemodialysis or peritoneal dialysis: a randomized trial. Am J Kidney Dis. 2007;50(6):989–1000.

    Article  CAS  PubMed  Google Scholar 

  47. Roger SD, Locatelli F, Woitas RP, Laville M, Tobe SW, Provenzano R, Golper TA, Ruangkanchanasetr P, Lee HY, Wu KD, Nowicki M, Ladanyi A, Martínez-Castelao A, Beyer U, Dougherty FC. C.E.R.A. once every 4 weeks corrects anaemia and maintains haemoglobin in patients with chronic kidney disease not on dialysis. Nephrol Dial Transplant. 2011;26(12):3980–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  48. Takahashi K, Totsune K, Imai Y, Sone M, Nozuki M, Murakami O, Sekino H, Mouri T. Plasma concentrations of immunoreactive-endothelin in patients with chronic renal failure treated with recombinant human erythropoietin. Clin Sci (Lond). 1993;84(1):47–50.

    Article  CAS  Google Scholar 

  49. Bode-Böger SM, Böger RH, Kuhn M, Radermacher J, Frölich JC. Recombinant human erythropoietin enhances vasoconstrictor tone via endothelin-1 and constrictor prostanoids. Kidney Int. 1996;50(4):1255–61.

    Article  PubMed  Google Scholar 

  50. Vaziri ND, Zhou XJ, Smith J, Oveisi F, Baldwin K, Purdy RE. In vivo and in vitro pressor effects of erythropoietin in rats. Am J Phys. 1995;269(6 Pt 2):F838–45.

    CAS  Google Scholar 

  51. Neusser M, Tepel M, Zidek W. Erythropoietin increases cytosolic free calcium concentration in vascular smooth muscle cells. Cardiovasc Res. 1993;27(7):1233–6.

    Article  CAS  PubMed  Google Scholar 

  52. Eggena P, Willsey P, Jamgotchian N, Truckenbrod L, Hu MS, Barrett JD, Eggena MP, Clegg K, Nakhoul F, Lee DB. Influence of recombinant human erythropoietin on blood pressure and tissue renin-angiotensin systems. Am J Phys. 1991;261(5 Pt 1):E642–6.

    CAS  Google Scholar 

  53. Akimoto T, Kusano E, Ito C, Yanagiba S, Inoue M, Amemiya M, Ando Y, Asano Y. Involvement of erythropoietin-induced cytosolic free calcium mobilization in activation of mitogen-activated protein kinase and DNA synthesis in vascular smooth muscle cells. J Hypertens. 2001;19(2):193–202.

    Article  CAS  PubMed  Google Scholar 

  54. Hedley BD, Allan AL, Xenocostas A. The role of erythropoietin and erythropoiesis-stimulating agents in tumor progression. Clin Cancer Res. 2011;17(20):6373–80.

    Article  CAS  PubMed  Google Scholar 

  55. Patterson SD, Rossi JM, Paweletz KL, Fitzpatrick VD, Begley CG, Busse L, Elliott S, McCaffery I. Functional EpoR pathway utilization is not detected in primary tumor cells isolated from human breast, non-small cell lung, colorectal, and ovarian tumor tissues. PLoS One. 2015;10(3):e0122149.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  56. McKoy JM, Stonecash RE, Cournoyer D, Rossert J, Nissenson AR, Raisch DW, Casadevall N, Bennett CL. Epoetin-associated pure red cell aplasia: past, present, and future considerations. Transfusion. 2008;48(8):1754–62.

    Article  PubMed  PubMed Central  Google Scholar 

  57. Locatelli F, Aljama P, Bárány P, Canaud B, Carrera F, Eckardt KU, Hörl WH, Macdougal IC, Macleod A, Wiecek A, Cameron S, European Best Practice Guidelines Working Group. Revised European best practice guidelines for the management of anaemia in patients with chronic renal failure. Nephrol Dial Transplant. 2004;19(Suppl 2):ii1–47.

    PubMed  Google Scholar 

  58. KDOQI; National Kidney Foundation. KDOQI clinical practice guidelines and clinical practice recommendations for anemia in chronic kidney disease. Am J Kidney Dis. 2006;47(5 Suppl 3):S11–145.

    Google Scholar 

  59. Okazaki M, Komatsu M, Kawaguchi H, Tsuchiya K, Nitta K. Erythropoietin resistance index and the all-cause mortality of chronic hemodialysis patients. Blood Purif. 2014;37(2):106–12.

    Article  CAS  PubMed  Google Scholar 

  60. Costa NA, Kshirsagar AV, Wang L, Detwiler RK, Brookhart MA. Pretransplantation erythropoiesis-stimulating agent hyporesponsiveness is associated with increased kidney allograft failure and mortality. Transplantation. 2013;96(9):807–13.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  61. Thomas C, Thomas L. Biochemical markers and hematologic indices in the diagnosis of functional iron deficiency. Clin Chem. 2002;48(7):1066–76.

    CAS  PubMed  Google Scholar 

  62. Mast AE, Blinder MA, Lu Q, Flax S, Dietzen DJ. Clinical utility of the reticulocyte hemoglobin content in the diagnosis of iron deficiency. Blood. 2002;99(4):1489–91.

    Article  CAS  PubMed  Google Scholar 

  63. Thomas DW, Hinchliffe RF, Briggs C, Macdougall IC, Littlewood T, Cavill I, British Committee for Standards in Haematology. Guideline for the laboratory diagnosis of functional iron deficiency. Br J Haematol. 2013;161:639–48.

    Article  CAS  PubMed  Google Scholar 

  64. Coyne DW, Kapoian T, Suki W, Singh AK, Moran JE, Dahl NV, Rizkala AR, DRIVE Study Group. Ferric gluconate is highly efficacious in anemic hemodialysis patients with high serum ferritin and low transferrin saturation: results of the Dialysis Patients’ Response to IV Iron with Elevated Ferritin (DRIVE) study. J Am Soc Nephrol. 2007;18(3):975–84.

    Article  CAS  PubMed  Google Scholar 

  65. Pisani A, Riccio E, Sabbatini M, Andreucci M, Del Rio A, Visciano B. Effect of oral liposomal iron versus intravenous iron for treatment of iron deficiency anaemia in CKD patients: a randomized trial. Nephrol Dial Transplant. 2015;30(4):645–52.

    Article  CAS  PubMed  Google Scholar 

  66. Van Wyck DB, Roppolo M, Martinez CO, Mazey RM, McMurray S, United States Iron Sucrose (Venofer) Clinical Trials Group. A randomized, controlled trial comparing IV iron sucrose to oral iron in anemic patients with nondialysis-dependent CKD. Kidney Int. 2005;68(6):2846–56.

    Article  PubMed  Google Scholar 

  67. Qunibi WY, Martinez C, Smith M, Benjamin J, Mangione A, Roger SD. A randomized controlled trial comparing intravenous ferric carboxymaltose with oral iron for treatment of iron deficiency anaemia of non-dialysis-dependent chronic kidney disease patients. Nephrol Dial Transplant. 2011;26(5):1599–607.

    Article  CAS  PubMed  Google Scholar 

  68. Rampton D, Folkersen J, Fishbane S, Hedenus M, Howaldt S, Locatelli F, Patni S, Szebeni J, Weiss G. Hypersensitivity reactions to intravenous iron: guidance for risk minimization and management. Haematologica. 2014;99(11):1671–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  69. Litton E, Xiao J, Ho KM. Safety and efficacy of intravenous iron therapy in reducing requirement for allogeneic blood transfusion: systematic review and meta-analysis of randomised clinical trials. BMJ. 2013;347:f4822.

    Article  PubMed  PubMed Central  Google Scholar 

  70. Brookhart MA, Freburger JK, Ellis AR, Wang L, Winkelmayer WC, Kshirsagar AV. Infection risk with bolus versus maintenance iron supplementation in hemodialysis patients. J Am Soc Nephrol. 2013;24(7):1151–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  71. Toblli JE, Cao G, Angerosa M. Cardiovascular outcomes of intravenous iron in perspective of clinical trials and the use of different iron preparations. Int J Cardiol. 2015;187:196–7.

    Article  PubMed  Google Scholar 

  72. Kamanna VS, Ganji SH, Shelkovnikov S, Norris K, Vaziri ND. Iron sucrose promotes endothelial injury and dysfunction and monocyte adhesion/infiltration. Am J Nephrol. 2012;35(2):114–9.

    Article  CAS  PubMed  Google Scholar 

  73. National Clinical Guideline Centre (UK). Anaemia management in chronic kidney disease: partial update 2015. National Institute for Health and Care Excellence: Clinical Guidelines. London: Royal College of Physicians (UK); 2015. p. 65.

    Google Scholar 

  74. Chen N, Hao C, Peng X, Lin H, Yin A, Hao L, Tao Y, Liang X, Liu Z, Xing C, Chen J, Luo L, Zuo L, Liao Y, Liu B-C, Leong R, Wang C, Liu C, Neff T, Szczech L, Yu K-HP. Roxadustat for anemia in patients with kidney disease not receiving dialysis. N Engl J Med. 2019;381(11):1001–10.

    Article  PubMed  Google Scholar 

  75. Chen N, Hao C, Liu B-C, Lin H, Wang C, Xing C, Liang X, Jiang G, Liu Z, Li X, Zuo L, Luo L, Wang J, Zhao M-h, Liu Z, Cai G-Y, Hao L, Leong R, Wang C, Liu C, Neff T, Szczech L, Yu K-HP. Roxadustat treatment for anemia in patients undergoing long-term dialysis. N Engl J Med. 2019;381(11):1011–22.

    Article  PubMed  Google Scholar 

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  1. Centre for Kidney Disease, Second Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu, China

    Yi Fang & Weichun He

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    Junwei Yang

  2. Centre for Kidney Disease, Second Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu, China

    Weichun He

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Fang, Y., He, W. (2020). Anemia in Chronic Kidney Disease. In: Yang, J., He, W. (eds) Chronic Kidney Disease. Springer, Singapore. https://doi.org/10.1007/978-981-32-9131-7_10

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