Educational Symposium

Anemia, the Hypoxia-Inducible Factor System, and CKD

November 09, 2019 | 12:45 PM - 01:45 PM

Location: Liberty Ballroom, Marriott Marquis

Session Description

Recently, HIF-PHD inhibitors (hypoxia-inducible factor–prolyl hydroxylase domain) have been developed as an alternative therapy to exogenous erythropoietin. Exogenous erythropoietin is used extensively in the management of anemia, particularly among patients receiving dialysis, but although it successfully increases levels of hemoglobin, exogenous erythropoietin has also been associated with an increase in cardiovascular events. HIF-PHD inhibition can result in a short-term increase in HIF-regulated genes and may provide a more comprehensive and physiological approach to anemia, because the HIF system stimulates both renal and hepatic erythropoietin production, improves iron handling, and helps red blood cell maturation and proliferation. Several oral HIF-PHD inhibitor formulations are undergoing phase 3 clinical evaluation. Phase 2 studies demonstrated both an increase in hemoglobin and a decrease in ferritin, hepcidin, and cholesterol. On the other hand, the role of long-term HIF inhibition in inducing pulmonary artery hypertension and increasing glucose levels and malignancy risk is unknown.

This symposium discusses the biology of the HIF-PHD pathway and the results of published phase 2 and 3 studies examining the use of HIF-PHD inhibitors in the treatment of anemia among patients with CKD and ESKD.

Support is provided by an educational grant from AstraZeneca Pharmaceuticals LP in collaboration with FibroGen.

Learning Objective(s)

  • Describe the basic function of the HIF-PHD pathway in response to hypoxic conditions
  • Discuss the evidence for risks and potential benefits of HIF-PHD inhibitors in the treatment of anemia among patients with CKD, including patients receiving long-term dialysis

Learning Pathway(s)

  • Chronic Kidney Disease

Moderator

  • Jeffrey S. Berns, MD, FASN

Presentations

  • Introduction
    12:45 PM - 12:55 PM
    Jeffrey S. Berns, MD, FASN
  • The Biology of the HIF-PHD Pathway
    12:55 PM - 01:15 PM
    Pinelopi P. Kapitsinou, MD
  • HIF-PHD Inhibitors: Evidence from Phase 2 and 3 Clinical Investigations
    01:15 PM - 01:35 PM
    Steven Fishbane, MD
  • Questions and Answers
    01:35 PM - 01:45 PM