114/04/29 19:00 - 20:30

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線上課程

時段	主題	講師	主持人
19:00~20:30	Unlocking the Potential of CKD Anemia Treatment	蔡尚鋒 醫師

Anemia is a common and serious complication of chronic kidney disease (CKD), affecting both dialysis and non-dialysis patients. It significantly impairs quality of life, increases the risk of cardiovascular morbidity and mortality, and represents a major challenge in the comprehensive management of CKD. While traditional treatment with erythropoiesis-stimulating agents (ESAs) and iron supplementation has been the mainstay of care, these approaches come with limitations and potential safety concerns. In recent years, a new class of oral agents—hypoxia-inducible factor prolyl hydroxylase inhibitors (HIF-PHIs)—has emerged, offering an innovative and potentially safer strategy for correcting anemia in CKD. Among these, vadadustat has drawn particular attention for its unique clinical profile and therapeutic potential.

Vadadustat works by stabilizing hypoxia-inducible factor (HIF), thereby stimulating the transcription of endogenous erythropoietin and enhancing iron utilization through multiple mechanisms. This mode of action mimics the body’s natural response to hypoxia, promoting a more physiologic erythropoietic process. Importantly, vadadustat also improves iron metabolism by increasing the expression of genes involved in iron absorption and transport, such as transferrin and divalent metal transporter-1 (DMT1), while reducing levels of hepcidin, a key inhibitor of iron availability.

Clinical trials evaluating vadadustat in both dialysis-dependent and non–dialysis-dependent CKD populations have shown it to be effective in maintaining hemoglobin levels within target ranges. In patients on dialysis, vadadustat has demonstrated non-inferiority to darbepoetin alfa in terms of efficacy. In non-dialysis patients, although efficacy was comparable, cardiovascular safety signals differed slightly depending on geographic regions and patient subgroups. These findings highlight the importance of individualized treatment considerations and the need for further real-world data.

One of the major advantages of vadadustat is its oral administration, which offers a convenient and less invasive option compared to injectable ESAs. This can be particularly beneficial in non-dialysis patients who are managed in outpatient or home-based settings. In addition, vadadustat may reduce the dependence on intravenous iron, thereby simplifying treatment protocols and potentially lowering the risk of iron overload and infection.

As the treatment landscape for CKD-related anemia continues to evolve, vadadustat represents a promising step forward. It aligns with the current paradigm shift towards more holistic, patient-centered care—focusing not just on correcting lab values but also on improving long-term outcomes and quality of life. With its oral route, physiologic mechanism of action, and potential for better iron handling, vadadustat offers a novel tool in our therapeutic arsenal.
This presentation will explore the pathophysiological rationale, key clinical trial data, and practical considerations for integrating vadadustat into CKD anemia management. It will also address remaining challenges, including patient selection, monitoring strategies, and potential future directions. Ultimately, unlocking the full potential of vadadustat requires not only clinical insight but also a commitment to advancing individualized, evidence-based care in nephrology.

線上課程

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社團法人中華民國藥師公會全國聯合會專業1.8積分
社團法人中華民國糖尿病衛教學會乙類1分
社團法人台灣護理學會專業1.8積分
台灣腎臟醫學會B類1分
台灣內科醫學會B類1分
《實際學分數以各醫學會實際通過為主，包含審查中之各醫學會學分》