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


Jane S. Davis, DNP, CRNP
University of Alabama at Birmingham
Birmingham, AL
Ajay K. Singh, MBBS, FRCP, MBA
Senior Associate Dean for Postgraduate Medical Education
Director, Master in Medical Sciences in Clinical Investigation (MMSCI) program, Harvard Medical School
Physician, Renal Division
Brigham and Women's Hospital/ Dana Farber Cancer Institute, Boston, MA
Calvin J. Meaney, PharmD, BCPS
Clinical Associate Professor and Vice Chair for Research
Department of Pharmacy Practice
School of Pharmacy and Pharmaceutical Sciences
University at Buffalo, Buffalo, NY

Statement of Need

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

  • 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.

Supported by

Supported through an independent educational grant from GlaxoSmithKline.

Target Audience

Nephrologists, hematologists, primary care physicians, internists, hospitalists, endocrinologists, cardiologists, nurses, nurse practitioners, physician assistants, and pharmacists.

Credit Information

Jointly Accredited Provider

In support of improving patient care, Creative Educational Concepts, LLC, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

AMA PRA Category 1 Credit(s)™

Creative Educational Concepts, LLC, designates this enduring activity for a maximum of 1.00 AMA PRA Category 1 Credit(s). Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Accreditation Council for Pharmacy Education

This application-based activity is approved for 1.00 contact hours (0.1 CEUs) of continuing pharmacy credit JA0007101-0000-22-013-H01-P

American Nurses Credentialing Center

This activity is designated for 1.00 contact hour.

Disclosure Declaration

It is the policy of Creative Educational Concepts, LLC, (CEC) to ensure independence, balance, objectivity, and scientific rigor and integrity in all their CME/CE activities. Activity planners, faculty, peer reviewers, and CEC staff must disclose to the participants any relationships with ineligible entities whose products or devices may be mentioned in this CE activity, or with the commercial supporter of this CE activity. An ineligible entity is defined as any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients. Financial relationships may include research grants, consultant fees, travel, advisory boards, consultancy, speakers’ bureaus, other benefits, or having a self-managed equity interest in a company.

CEC has evaluated, identified, and mitigated any potential conflicts of interest through a rigorous content validation procedure, use of evidence-based data/research, and a multidisciplinary peer review process. The following information is for participant information only. It is not assumed that these relationships will have a negative impact on the presentations.

Ajay K. Singh, MBBS, FRCP, MBA–has disclosed that he receives salary or employment from Harvard University Medical School, Brigham & Women’s Hospital, an educational grant from GlaxoSmithKlein, and is an advisor or consultant for Bayer, GlaxoSmithKline, Nephrology Times, and Zydus,

Jane S. Davis, DNP, CRNP–has disclosed that she receives salary or employment from UAB, and is on the speakers’ bureau for Bayer.
Calvin J. Meaney, PharmD, BCPS–has disclosed that he receives salary or employment from Wolters Kluwer. He is an advisor or consultant to GlaxoSmithKline and was an advisor or consultant to Vifor Pharm, Inc.

Peer Reviewer:
Erin Spencer, PharmD–has no relevant financial relationships to disclose in relation to the content of this activity.

CEC Staff/Planners:
Susan H. Gitzinger, PharmD, MPA–has no relevant financial relationships to disclose in relation to the content of this activity.
Jessica Hall–has no relevant financial relationships to disclose in relation to the content of this activity.

Faculty of this CME/CE activity may include discussions of products or devices that are not currently labeled for use by the FDA. The faculty have been informed of their responsibility to disclose to the audience if they will be discussing off-label or investigational uses (any uses not approved by the FDA) of products or devices. CEC, the faculty, and any commercial supporter of this activity do not endorse the use of any product outside of the FDA labeled indications. Medical professionals should not utilize the procedures, products, or diagnosis techniques discussed during this activity without evaluation of their patient for contraindications or dangers of use.

Obtaining Credit

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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
Activity Date: 11/01/2022