Anemia Management in Chronic Kidney Disease
Summary
Anemia is a frequent and consequential complication of chronic kidney disease (CKD), arising principally from reduced endogenous erythropoietin production, iron deficiency and chronic inflammation. Left untreated, anemia in CKD is associated with fatigue, diminished exercise tolerance, poorer quality of life and an elevated risk of cardiovascular events and progression to end-stage renal disease. Traditional management has centred on correcting iron deficits through oral or intravenous supplementation and administering erythropoiesis-stimulating agents to achieve target haemoglobin levels. However, variable response to therapy, safety concerns around high-dose erythropoiesis-stimulating agents and the burden of intravenous access have driven the search for novel approaches. Recent advances include oral hypoxia-inducible factor stabilisers that boost endogenous erythropoietin and improve iron mobilization by reducing hepcidin, and anti-inflammatory strategies aimed at restoring iron homeostasis. Emerging evidence supports a personalised paradigm in which iron status, inflammatory markers and patient preferences guide choice of therapy, with the dual aims of optimising haemoglobin, minimising adverse effects and enhancing functional capacity across the CKD population worldwide.
Research from Nature Portfolio
No recent Nature Portfolio content available.
Anemia Management in Chronic Kidney Disease publication trend
The graph below shows the total number of articles in anemia management in chronic kidney disease across all publications each year (not limited to Nature Index journals).
Technical terms
Erythropoiesis-stimulating agents (ESA): Synthetic or recombinant compounds that mimic endogenous erythropoietin to stimulate red blood cell production in the bone marrow.
Hypoxia-inducible factor prolyl hydroxylase inhibitors (HIF-PHIs): A class of oral drugs that stabilise hypoxia-inducible factors, promoting endogenous erythropoietin synthesis and enhancing iron mobilisation by suppressing hepcidin.
Hepcidin: A liver-derived peptide hormone that regulates systemic iron balance by controlling intestinal iron absorption and release from macrophage stores; elevated levels inhibit iron availability.
References
- Effect of Ziltivekimab on Determinants of Hemoglobin in Patients with CKD Stage 3–5: An Analysis of a Randomized Trial (RESCUE). Journal of the American Society of Nephrology (2023).
- Anemia in Chronic Kidney Disease: From Pathophysiology and Current Treatments, to Future Agents. Frontiers in Medicine (2021).
- Impact of chronic kidney disease and anemia on health-related quality of life and work productivity: analysis of multinational real-world data. BMC Nephrology (2020).
About these summaries
This Nature Research Intelligence Topic summary is created with the cited references and a large language model. We take care to ground generated text with facts, and have systems in place to gain human feedback on the overall quality of the process in line with our AI principles. We strive to create accurate and useful summaries for people unfamiliar with the research topic and that supports this goal. These pages are a beta release and will be updated as we learn how best to help people gain value from a research topic summary.
Turn complex research questions into confident strategic decisions
When you're under pressure to set direction, justify investment, or understand your competitive position, you need more than raw data — you need trusted insights you can act on.
Benchmark your performance against global peers using robust, methodologically sound analysis.
Combine quantitative metrics with qualitative expert insight to uncover strengths, gaps and emerging opportunities.
Gain tailored, decision-ready recommendations aligned to your strategic priorities.
Talk to us to learn more about our data dashboards and bespoke strategy reports.
Grow research skills, confidence and careers with training built for every stage of the research lifecycle.
Developed with Nature Portfolio journal Editors and internationally renowned experts. Discover three ways to learn:
Self-paced, online courses in convenient bite-sized units, covering key skills across scientific writing, publishing, grant writing, data analysis, and more.
Expert trainer-led workshops with hands-on exercises and real-time feedback across core research skills, delivered via interactive group sessions.
Editor-led workshops combining core principles in writing and publishing, personalised 1:1 feedback from Nature Portfolio Editors and hands-on exercises.
Explore course catalogues and workshop agendas, enquire about the options or request institutional pricing.