Anemia Management in Chronic Kidney Disease: A Comparative Evaluation of Hypoxia-Inducible Factor-Prolyl Hydroxylase Domain (HIF-PHD) Inhibitor(s) and Erythropoiesis Stimulating Agents(ESAs)

Chronic Kidney Disease (CKD) is a prevalent condition worldwide, with a significant number of patients progressing to end-stage renal disease (ESRD) and requiring dialysis. These patients often have anemia, which is a common complication of CKD. This is associated with poorer quality of life, increased healthcare costs, and a higher risk of mortality.

Traditionally, erythropoiesis-stimulating agents (ESAs) have been the standard of care for managing anemia in CKD patients undergoing dialysis. However, recent research has explored the potential of Hypoxia-Inducible Factor-Prolyl Hydroxylase Domain (HIF-PHD) inhibitors as an alternative option.

The potential benefits of HIF-PHD inhibitors include- they are orally-administered, effectively raise or preserve hemoglobin levels, and induce an increase in endogenous EPO production within the desired physiological range. They exert control over iron metabolism, particularly by reducing hepcidin levels, enhance iron absorption, and remain unaffected by inflammation. Additionally, they may contribute to reducing cholesterol levels and have demonstrated potential cardioprotective effects with decreased inflammation.

This study aims to evaluate the effectiveness and safety of HIF-PHD inhibitor(s) against the standard treatment in CKD patients with anemia. Further, the estimation of safety, cost of treatment and quality of life of anemic chronic kidney disease patients undergoing dialysis are also proposed.