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Abstract(s)
A Doença renal crónica (DRC) é uma patologia complexa e debilitante que afeta milhões de indivíduos em todo o mundo. Entre as várias complicações associadas à DRC, a anemia é uma condição prevalente e clinicamente significativa com impacto considerável na qualidade de vida e no prognóstico global dos doentes.
A anemia associada à DRC tem uma etiologia multifatorial surgindo de uma complexa interação de vários mecanismos fisiopatológicos. Destacam-se o défice de produção de eritropoetina e as alterações do metabolismo do ferro, levando a uma produção inadequada de eritrócitos e consequente redução da capacidade de fornecer oxigénio aos tecidos. Entre as diversas consequências, exemplificam-se a fadiga e diminuição da qualidade de vida, o comprometimento da função cognitiva e as complicações cardiovasculares.
O tratamento passou por avanços substanciais nos últimos anos com a introdução de novas abordagens terapêuticas e uma compreensão mais profunda da fisiopatologia subjacente. O objetivo do tratamento consiste não só em melhorar os níveis de hemoglobina, mas também em aliviar os sintomas, melhorar a qualidade de vida dos doentes e reduzir o risco de eventos cardiovasculares.
Atualmente, os agentes estimuladores da eritropoiese e a suplementação com ferro constituem a primeira linha de tratamento nestes doentes estimulando a produção de eritrócitos e otimizando a eritropoiese.
Novas opções terapêuticas, como os estabilizadores do HIF (hypoxia inducible factor), demonstraram eficácia no tratamento da anemia através de mecanismos mais fisiológicos, sendo alternativas cada vez mais presentes no tratamento destes doentes.
Chronic Kidney Disease (CKD) is a complex and debilitating condition that affects millions of individuals around the world. Among the various complications associated with CKD, anemia is a prevalent and clinically significant condition with considerable impact on quality of life and overall prognosis of patients. CKD-associated anemia has a multifactorial etiology arising from a complex interplay of several pathophysiological mechanisms. Of particular note is the deficit in erythropoietin production and changes in iron metabolism, leading to an inadequate production of erythrocytes and consequent reduction in the ability to supply oxygen to the tissues. Among the various consequences, fatigue and decreased quality of life, impairment of cognitive function and cardiovascular complications are exemplified. Treatment has undergone substantial advances in recent years with the introduction of new therapeutic approaches and a deeper understanding of the underlying pathophysiology. The aim of treatment is not only to improve hemoglobin levels but also to relieve symptoms, improve the quality of life of patients and reduce the risk of cardiovascular events. Currently, erythropoiesis-stimulating agents and iron supplementation are the first line of treatment in these patients, stimulating erythrocyte production and optimizing erythropoiesis. New therapeutic options, such as HIF (hypoxia inducible factor) stabilizers, have demonstrated efficacy in the treatment of anemia through more physiological mechanisms, and are increasingly present alternatives in the treatment of these patients.
Chronic Kidney Disease (CKD) is a complex and debilitating condition that affects millions of individuals around the world. Among the various complications associated with CKD, anemia is a prevalent and clinically significant condition with considerable impact on quality of life and overall prognosis of patients. CKD-associated anemia has a multifactorial etiology arising from a complex interplay of several pathophysiological mechanisms. Of particular note is the deficit in erythropoietin production and changes in iron metabolism, leading to an inadequate production of erythrocytes and consequent reduction in the ability to supply oxygen to the tissues. Among the various consequences, fatigue and decreased quality of life, impairment of cognitive function and cardiovascular complications are exemplified. Treatment has undergone substantial advances in recent years with the introduction of new therapeutic approaches and a deeper understanding of the underlying pathophysiology. The aim of treatment is not only to improve hemoglobin levels but also to relieve symptoms, improve the quality of life of patients and reduce the risk of cardiovascular events. Currently, erythropoiesis-stimulating agents and iron supplementation are the first line of treatment in these patients, stimulating erythrocyte production and optimizing erythropoiesis. New therapeutic options, such as HIF (hypoxia inducible factor) stabilizers, have demonstrated efficacy in the treatment of anemia through more physiological mechanisms, and are increasingly present alternatives in the treatment of these patients.
Description
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2023
Keywords
Doença renal crónica Anemia Hematínicos Eritropoiese Hypoxia inducible factor Ferro Nefrologia