Hypertension Induced by Hypoxia‐Inducible Factor Prolyl Hydroxylase Inhibitors in Treating Anemia in Patients With Chronic Kidney Disease: A Mini‐Review

ABSTRACT Hypoxia‐inducible factor prolyl hydroxylase (HIF‐PH) inhibitors are a new class of agents for the treatment of anemia in chronic kidney disease (CKD). Unlike traditional treatments such as erythropoiesis‐stimulating agents (ESAs), HIF‐PH inhibitors are orally administered drugs and may incr...

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Main Authors: Wei Zhang, Yan Li, Ji‐Guang Wang
Format: Article
Language:English
Published: Wiley 2024-12-01
Series:The Journal of Clinical Hypertension
Subjects:
Online Access:https://doi.org/10.1111/jch.14924
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author Wei Zhang
Yan Li
Ji‐Guang Wang
author_facet Wei Zhang
Yan Li
Ji‐Guang Wang
author_sort Wei Zhang
collection DOAJ
description ABSTRACT Hypoxia‐inducible factor prolyl hydroxylase (HIF‐PH) inhibitors are a new class of agents for the treatment of anemia in chronic kidney disease (CKD). Unlike traditional treatments such as erythropoiesis‐stimulating agents (ESAs), HIF‐PH inhibitors are orally administered drugs and may increase endogenous erythropoietin and improve iron homeostasis. However, a significant concern is their possible side effect on blood pressure. The current mini‐review summarizes the data of 26 randomized controlled (placebo or ESAs) trials on six different HIF‐PH inhibitors with regard to their potential influence on blood pressure and hypertension in the management of anemia in CKD. Overall, the use of HIF‐PH inhibitors was associated with a higher risk of hypertension than placebo (pooled risk ratio 1.36, 95% confidence interval [CI] 1.16–1.59), but a lower risk of hypertension than ESA treatment (pooled risk ratio 0.92, 95% CI 0.86–0.98), especially in CKD patients not undergoing dialysis (pooled risk ratio 0.85, 95% CI 0.73–0.98). This review highlights the importance of blood pressure monitoring during the treatment of HIF‐PH inhibitors, especially out‐of‐office blood pressure measurement.
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series The Journal of Clinical Hypertension
spelling doaj-art-5f8519f8c9ab46f6af2df935715b317d2024-12-18T19:30:42ZengWileyThe Journal of Clinical Hypertension1524-61751751-71762024-12-0126121375138310.1111/jch.14924Hypertension Induced by Hypoxia‐Inducible Factor Prolyl Hydroxylase Inhibitors in Treating Anemia in Patients With Chronic Kidney Disease: A Mini‐ReviewWei Zhang0Yan Li1Ji‐Guang Wang2Department of Cardiovascular Medicine, State Key Laboratory of Medical Genomics, Shanghai Key Laboratory of Hypertension, Shanghai Institute of Hypertension Ruijin Hospital, Shanghai Jiao Tong University School of Medicine Shanghai ChinaDepartment of Cardiovascular Medicine, State Key Laboratory of Medical Genomics, Shanghai Key Laboratory of Hypertension, Shanghai Institute of Hypertension Ruijin Hospital, Shanghai Jiao Tong University School of Medicine Shanghai ChinaDepartment of Cardiovascular Medicine, State Key Laboratory of Medical Genomics, Shanghai Key Laboratory of Hypertension, Shanghai Institute of Hypertension Ruijin Hospital, Shanghai Jiao Tong University School of Medicine Shanghai ChinaABSTRACT Hypoxia‐inducible factor prolyl hydroxylase (HIF‐PH) inhibitors are a new class of agents for the treatment of anemia in chronic kidney disease (CKD). Unlike traditional treatments such as erythropoiesis‐stimulating agents (ESAs), HIF‐PH inhibitors are orally administered drugs and may increase endogenous erythropoietin and improve iron homeostasis. However, a significant concern is their possible side effect on blood pressure. The current mini‐review summarizes the data of 26 randomized controlled (placebo or ESAs) trials on six different HIF‐PH inhibitors with regard to their potential influence on blood pressure and hypertension in the management of anemia in CKD. Overall, the use of HIF‐PH inhibitors was associated with a higher risk of hypertension than placebo (pooled risk ratio 1.36, 95% confidence interval [CI] 1.16–1.59), but a lower risk of hypertension than ESA treatment (pooled risk ratio 0.92, 95% CI 0.86–0.98), especially in CKD patients not undergoing dialysis (pooled risk ratio 0.85, 95% CI 0.73–0.98). This review highlights the importance of blood pressure monitoring during the treatment of HIF‐PH inhibitors, especially out‐of‐office blood pressure measurement.https://doi.org/10.1111/jch.14924chronic kidney diseaseerythropoietinhypertensionhypoxia‐inducible factorprolyl hydroxylase inhibitorsrenal anemia
spellingShingle Wei Zhang
Yan Li
Ji‐Guang Wang
Hypertension Induced by Hypoxia‐Inducible Factor Prolyl Hydroxylase Inhibitors in Treating Anemia in Patients With Chronic Kidney Disease: A Mini‐Review
The Journal of Clinical Hypertension
chronic kidney disease
erythropoietin
hypertension
hypoxia‐inducible factor
prolyl hydroxylase inhibitors
renal anemia
title Hypertension Induced by Hypoxia‐Inducible Factor Prolyl Hydroxylase Inhibitors in Treating Anemia in Patients With Chronic Kidney Disease: A Mini‐Review
title_full Hypertension Induced by Hypoxia‐Inducible Factor Prolyl Hydroxylase Inhibitors in Treating Anemia in Patients With Chronic Kidney Disease: A Mini‐Review
title_fullStr Hypertension Induced by Hypoxia‐Inducible Factor Prolyl Hydroxylase Inhibitors in Treating Anemia in Patients With Chronic Kidney Disease: A Mini‐Review
title_full_unstemmed Hypertension Induced by Hypoxia‐Inducible Factor Prolyl Hydroxylase Inhibitors in Treating Anemia in Patients With Chronic Kidney Disease: A Mini‐Review
title_short Hypertension Induced by Hypoxia‐Inducible Factor Prolyl Hydroxylase Inhibitors in Treating Anemia in Patients With Chronic Kidney Disease: A Mini‐Review
title_sort hypertension induced by hypoxia inducible factor prolyl hydroxylase inhibitors in treating anemia in patients with chronic kidney disease a mini review
topic chronic kidney disease
erythropoietin
hypertension
hypoxia‐inducible factor
prolyl hydroxylase inhibitors
renal anemia
url https://doi.org/10.1111/jch.14924
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AT jiguangwang hypertensioninducedbyhypoxiainduciblefactorprolylhydroxylaseinhibitorsintreatinganemiainpatientswithchronickidneydiseaseaminireview