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Uremic Toxins Affect Erythropoiesis during the Course of Chronic Kidney Disease: A Review

Eya Hamza1, Laurent Metzinger1, Valérie Metzinger-Le Meuth1,2

  • 1HEMATIM UR 4666, C.U.R.S, University of Picardie Jules Verne, CEDEX 1, 80025 Amiens, France.

Cells
|September 9, 2020
PubMed

Insights

Chronic kidney disease (CKD) anemia stems from uremic toxins impairing red blood cell production. Understanding these molecular mechanisms can guide new treatments for this common CKD complication.

Area of Science:

  • Nephrology
  • Hematology
  • Toxicology

Background:

  • Chronic kidney disease (CKD) is a global health issue with progressive kidney failure.
  • Anemia is a frequent and serious complication of CKD, impacting nearly all end-stage renal disease patients.
  • CKD anemia contributes to cardiovascular disease, accelerated renal failure, and mortality.

Purpose of the Study:

  • To review the molecular mechanisms of anemia in CKD caused by uremic toxins.
  • To highlight key uremic toxins and their impact on erythropoiesis.
  • To explore potential therapeutic targets for CKD-associated anemia.

Main Methods:

  • Literature review focusing on uremic toxins and their effects on anemia in CKD.
  • Analysis of molecular pathways involved in erythropoiesis impairment.
  • Synthesis of current understanding of CKD-related anemia pathophysiology.

Main Results:

  • Uremic toxins accumulate in CKD, impairing erythropoietin synthesis and red blood cell production.
  • Deficiencies in erythropoietin and iron are primary drivers of CKD-associated anemia.
  • Molecular mechanisms involve compromised red blood cell growth and differentiation in bone marrow.

Conclusions:

  • Uremic toxins significantly contribute to the development of anemia in CKD patients.
  • Targeting molecular mechanisms of uremic toxicity offers a pathway for novel anemia treatments.
  • Newer erythropoiesis-stimulating agents represent a step towards addressing CKD anemia.

Keywords:
anemiachronic kidney diseaseerythropoiesiserythropoietinindoxyl sulfateironuremic toxins

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