Navigating Novel Terrain in Anemia of Chronic Kidney Disease: A Patient-centric Review of Disease State, Current Chasms in Care, and the Future Promise of HIF-PH Inhibition

Target Audience
This activity is designed to meet the educational needs of nephrologists, hematologists, primary care physicians, internists, hospitalists, endocrinologists, cardiologists, nurses, nurse practitioners, physician assistants, and pharmacists.

Program Overview
To facilitate timely diagnosis and rapid treatment initiation for anemia in CKD, the multidisciplinary and interprofessional CKD-anemia treatment team should be aware of the significant impact of anemia on patient quality of life, progression of CKD, and cardiovascular events. Erythropoietin-stimulating agents (ESAs) are associated with significant cardiovascular safety-related concerns, but the emergence of the oral hypoxia-inducible factor prolyl hydroxylase inhibitors (HIF-PHIs) may improve erythropoiesis without the undesirable downstream effects of ESAs. However, HIF-PHIs place in therapy has not yet been fully elucidated. Here, join the interprofessional team of Dr. Ajay Singh, Dr. Jane Davis, and Dr. Calvin Meaney as they explore an incisive review of current CKD-anemia treatment and diagnostic challenges, as well as the evidentiary base for HIF-PHI utilization in CKD-anemia that establishes context for the future of these agents. In conclusion, a practical discussion of real-world patient case scenarios will be presented, to provide learners with context of the multiple comorbidities, complexities, diagnostic challenges, and barriers to appropriate treatment of CKD-anemia.

Learning Objectives
Upon completion of this activity, participants should be better able to:

Review the prevalence and pathophysiology of anemia of CKD, emphasizing the multifaceted, patient-centric burden of disease.
Evaluate potential causes of CKD-anemia underdiagnosis and undertreatment, and propose adaptive, evidence-based solutions to optimize care.
Appraise current clinical controversies in the management of CKD-anemia, highlighting the safety concerns posed by ESAs, and discuss how these challenges have prompted the need for novel therapeutic approaches.
Examine hypoxia-inducible factor (HIF) as a key pathophysiologic component and a novel treatment target in CKD-anemia.
Summarize the expanding clinical trial evidentiary base and regulatory landscape for HIF-PH inhibitors in CKD-anemia management.
Use a practical, case-based format to design individualized and multidisciplinary treatment plans for patients with CKD-anemia that are safe, effective, and promote equitable solutions to healthcare disparities.