铁调素与肾性贫血相关影响因素的研究进展

摘要

慢性肾脏病(chronic kidney disease,CKD)的全球患病率是8％～16％.贫血是CKD的主要并发症之一.引起肾性贫血有多种因素,如红细胞生成素(erythropoietin,EPO)不足、缺铁、失血、炎症、缺乏维生素D、铁调素、继发性甲状旁腺功能亢进(secondary hyperparathyroidism,SHPT)及肥胖等.其中引起肾性贫血的主要原因是红细胞生成素不足及铁的缺乏.因此,肾性贫血的治疗主要是红细胞生成刺激剂(erythropoiesis stimulater agent,ESA)的使用和补铁.最新研究发现铁调素(hepcidin)与肾性贫血关系密切,可能与机体的铁状态、炎症状态及肾小球滤过率(glomeralar filtration rate,GFR)等相关.尤其在功能性缺铁中发挥重要调节作用,本文综述了铁调素与肾性贫血的相关影响因素,对临床治疗及研究肾性贫血提供了基础.%The global incidence of chronic kidney disease (CKD) is as high as 8～16％.Anemia is one of the main complications in CKD patients.Factors causing renal anemia include erythropoietin deficiency,iron deficiency,blood loss,inflammation,vitamin D deficiency,hepcidin,secondary hyperparathyroidism and obesity,in which erythropoietin and iron deficiencies are the main causes for renal anemia.Therefore erythropoiesis stimulator and iron supplementation are two important therapies for renal anemia.Recent studies have found that hepcidin is closely related to renal anemia and is possibly related to iron state,inflammatory state and glomerular filtration rate.Hepcidin plays an important role in the regulation of functional iron deficiency.This article reviews the factors relating to hepcidin and renal anemia,and provides a basis for clinical treatment and study of renal anemia.