Emerging Therapies for Anemia in Chronic Kidney Disease: An Updated Review
Anemia is a common and significant consequence of chronic kidney disease (CKD), affecting quality of life, cardiovascular events, hospitalization rates and mortality. Conventionally, management of renal anemia has relied on iron supplementation, erythropoiesis-stimulating agents (ESAs) and blood transfusions. However, limitations associated with these therapies, including- iron-related adverse effects, ESA hypo-responsiveness and cardiovascular safety concerns have prompted the development of novel therapeutic strategies. Recent advances in understanding the molecular mechanisms underlying renal anemia have led to the emergence of hypoxia-inducible factor prolyl hydroxylase inhibitors (HIF-PHIs), which stimulate endogenous erythropoietin production and improve iron utilization. Additional emerging approaches include hepcidin-targeted therapies, ferroprotein modulators, anti-inflammatory agents and novel erythropoietic pathways. This review summarizes current evidence regarding the efficacy, safety and clinical applications of emerging therapies for anemia in CKD and discusses future perspectives in personalized renal anemia management.