Hypoxia-Inducible Factor Prolyl Hydroxylase Inhibitors for Treatment of Anemia in Chronic Kidney Disease: Guidelines for South Asia

Indian J Nephrol. 2025 Mar-Apr;35(2):129-167. doi: 10.25259/ijn_389_23. Epub 2025 Feb 25.

Abstract

This guideline addresses the use of hypoxia-inducible factor prolyl hydroxylase inhibitors (HIF-PHIs) in patients >18 years with chronic kidney disease (CKD) and anemia in South Asia (Bangladesh, Bhutan, Nepal, India, Pakistan, Sri Lanka). It also summarizes recommendations for anemia treatment for individual HIF-PHI molecules under two categories: dialysis-dependent and non-dialysis-dependent CKD patients. The recommendations do not apply to pediatric (≤12 years) and adolescent (12 to 18) patients or those with primary anemia or anemia secondary to other causes such as blood loss, cancer (any type), polycystic kidney disease and infectious diseases.

Keywords: Anemia; Chronic kidney disease; Dialysis; Guidelines; HIF-PHIs.