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HIF Stabilizers: Will They Have a Place?

  • 1 Jay Wish, MD, is medical director of the outpatient dialysis unit at Indiana University Hospital and professor of clinical medicine at Indiana University School of Medicine in Indianapolis, IN.
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Hypoxia-inducible factor prolyl-hydroxylase inhibitors (commonly known as HIF stabilizers or PHIs) belong to a new class of orally administered drugs to treat anemia in patients with CKD.

Hypoxia-inducible factor (HIF) is present in nearly all tissues and constitutes the body’s natural mechanism to adapt to hypoxic conditions. HIF is a heterodimer consisting of an alpha and beta subunit. The alpha subunit is rapidly degraded by a proline hydroxylase (PH) enzyme in the presence of oxygen, thereby preventing the heterodimerization with the beta subunit and its transcriptional effects on over 4000 genes, depending on the tissue.

Activation of these genes leads

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