Hypoxia-inducible factor prolyl hydroxylase inhibitor in the treatment of anemia in chronic kidney disease

Yu Kurata, Tetsuhiro Tanaka, Masaomi Nangaku

Research output: Contribution to journalReview articlepeer-review

13 Citations (Scopus)


Purpose of reviewHypoxia-inducible factor prolyl hydroxylase inhibitors (HIF-PHIs) are orally active small molecules and are launched as novel therapeutic agents for anemia in chronic kidney disease (CKD). In contrast to conventional exogenous erythropoietin (EPO) administration, HIF-PHIs stimulate endogenous EPO production and improve iron metabolism via stabilization of hypoxia-inducible factor (HIF). This review summarizes the mechanism of action, the results of clinical trials, and future perspectives of HIF-PHIs.Recent findingsSix HIF-PHIs are currently under phase III studies, some of which have been already completed. According to the results of clinical trials, HIF-PHIs increased and maintained hemoglobin levels in both nondialysis-dependent and dialysis-dependent CKD patients with physiological EPO concentrations. HIF-PHIs also improved iron utilization and were comparably effective regardless of underlying inflammation and iron status.SummaryHIF-PHIs have several advantages including oral administration, physiological EPO secretion, and improved iron utilization. Undoubtedly, HIF-PHIs will pave the new way in the field of treatment of anemia in CKD, but it should be noted that HIFs have pleiotropic effects on a plethora of cellular functions, which might lead to either beneficial or undesirable off-target effects. Intensive postmarketing surveillance is crucially important to identify unexpected consequences.

Original languageEnglish
Pages (from-to)414-422
Number of pages9
JournalCurrent Opinion in Nephrology and Hypertension
Issue number4
Publication statusPublished - 2020 Jul 1


  • anemia
  • erythropoietin
  • hypoxia-inducible factor
  • prolyl hydroxylase inhibitors

ASJC Scopus subject areas

  • Internal Medicine
  • Nephrology


Dive into the research topics of 'Hypoxia-inducible factor prolyl hydroxylase inhibitor in the treatment of anemia in chronic kidney disease'. Together they form a unique fingerprint.

Cite this