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Dialyse aktuell 2020; 24(10): 417-423
DOI: 10.1055/a-1190-8573
Schwerpunkt
Nephrologie

Renale Anämie bei Kindern

Neue Diagnostik und Therapie
Joanna Śladowska-Kozłowska
1   Sektion für Pädiatrische Nephrologie, Zentrum für Kinder- und Jugendmedizin, Universitätsklinikum Heidelberg, Heidelberg
,
Franz Schaefer
1   Sektion für Pädiatrische Nephrologie, Zentrum für Kinder- und Jugendmedizin, Universitätsklinikum Heidelberg, Heidelberg
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ZUSAMMENFASSUNG

Kinder und Jugendliche sind durch eine Anämie bei chronischen Nierenerkrankungen besonders gefährdet. Eine nicht ausreichende Synthese von Erythropoietin, eine reduzierte Erythrozytenlebensdauer, Eisenmangel und Blutverluste steigern das Risiko einer renalen Anämie mit zunehmendem Grad der chronischen Niereninsuffizienz (CKD). Keiner der bislang verfügbaren diagnostischen Parameter reicht allein aus, um den Eisenstatus des Blutes exakt zu beurteilen. Daher sollte die Diagnose erweitert werden und der Retikulozyten-Hämoglobin-Gehalt bzw. das -Äquivalent (CHr/RET-He) gemessen werden. Die Werte spiegeln die aktuelle Bioverfügbarkeit von Eisen für die Erythropoese wider. Zur Standardbehandlung der renalen Anämie gehören seit wenigen Jahrzehnten die Erythropoese stimulierenden Wirkstoffe (ESAs). Diese Therapie schlägt jedoch nicht immer ausreichend an. Doch es gibt es neue Therapieansätze, die hier vorgestellt werden. Hierbei könnten v. a. die oral verabreichbaren HIF-Stabilisatoren (HIF: Hypoxie induzierbarer Faktor) bald eine vielversprechende Therapiealternative für Kinder bieten.



Publikationsverlauf

Artikel online veröffentlicht:
17. Dezember 2020

© 2020. Thieme. All rights reserved.

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