Efficacy and safety of hypoxia-inducible factor-prolyl hydroxylase inhibitor treatment for anemia in chronic kidney disease: an umbrella review of meta-analyses

作者全名："Ren, Song; Yao, Xiaoxiu; Li, Yi; Zhang, Ying; Tong, Chao; Feng, Yunlin"

作者地址："[Ren, Song; Li, Yi; Feng, Yunlin] Univ Elect Sci & Technol China, Sichuan Prov Peoples Hosp, Dept Nephrol, Chengdu, Peoples R China; [Yao, Xiaoxiu] Damian Honghe Community Hlth Serv Ctr Longquanyi D, Dept Hlth Management, Chengdu, Peoples R China; [Zhang, Ying] Univ Elect Sci & Technol China, Sichuan Prov Peoples Hosp, Dept Ophthalmol, Chengdu, Peoples R China; [Tong, Chao] Chongqing Med Univ, Affiliated Hosp 1, State Key Lab Maternal & Fetal Med Chongqing Munic, Chongqing, Peoples R China; [Feng, Yunlin] Univ New South Wales, George Inst Global Hlth, Renal Div, Sydney, NSW, Australia"

通信作者："Feng, YL (通讯作者)，Univ Elect Sci & Technol China, Sichuan Prov Peoples Hosp, Dept Nephrol, Chengdu, Peoples R China.; Tong, C (通讯作者)，Chongqing Med Univ, Affiliated Hosp 1, State Key Lab Maternal & Fetal Med Chongqing Munic, Chongqing, Peoples R China.; Feng, YL (通讯作者)，Univ New South Wales, George Inst Global Hlth, Renal Div, Sydney, NSW, Australia."

来源：FRONTIERS IN PHARMACOLOGY

ESI学科分类：PHARMACOLOGY & TOXICOLOGY

WOS号：WOS:001125890100001

JCR分区：Q1

影响因子：4.4

年份：2023

卷号：14

期号：　

开始页：　

结束页：　

文献类型：Review

关键词：hypoxia-inducible factor-prolyl hydroxylase inhibitor; anemia; chronic kidney disease; hemoglobulin; iron metabolism; safety; umbrella review

摘要："The objective was to provide a comprehensive summary of existing evidence on the efficacy and safety of hypoxia-inducible factor-prolyl hydroxylase inhibitors (HIF-PHIs) for the treatment of anemia in chronic kidney disease (CKD). A systematic search was conducted in the Medline, Embase, and Cochrane databases. Only meta-analyses that evaluated the efficacy and safety of HIF-PHI treatment for anemia in CKD were included. The efficacy outcomes included hemoglobin levels and iron metabolism indices, while the safety outcomes were assessed by examining adverse events. The qualities of methodologies and evidence were assessed using the AMSTAR 2 system and the NutriGrade tool, respectively. Fourteen meta-analyses, comprising 105 distinct comparisons, were included. The comparisons were backed by evidence of high, moderate, and low levels, distributed in approximately equal proportions. None of the studies were deemed to possess a high level of confidence. In both the overall and individual treatment groups of HIF-PHI, there was an increase in the levels of hemoglobin, transferrin, and transferrin saturation, while the levels of hepcidin and total iron binding capacity decreased. Serum ferritin exhibited a reduction to some extent, while serum iron did not show significant alterations following HIF-PHI treatments. There were no notable disparities in safety outcomes between the HIF-PHI and erythropoietin stimulating agents or placebo groups. This umbrella review suggests that HIF-PHI treatment can effectively increase hemoglobin levels in CKD patients and enhance iron metabolism by decreasing hepcidin levels and improving iron transport. The safety profiles of HIF-PHIs were generally comparable to those of ESA therapies or placebos."

基金机构："Sichuan Science and Technology Program [2023YFSY0027]; Australian Government Research Training Program Scholarship (RTP); Faculty of Medicine, UNSW"

基金资助正文："The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work was partly supported by Sichuan Science and Technology Program (2023YFSY0027). YF is also supported by an Australian Government Research Training Program Scholarship (RTP) for study toward a PhD in the Faculty of Medicine, UNSW."