Vadadustat
Vadadustat
Vadadustat is a pharmaceutical drug that acts as a hypoxia-inducible factor prolyl hydroxylase inhibitor (HIF-PHI). It is primarily used in the treatment of anemia associated with chronic kidney disease (CKD). Vadadustat works by stabilizing the hypoxia-inducible factor (HIF), which leads to increased production of endogenous erythropoietin and improved iron metabolism, thereby stimulating erythropoiesis.
Mechanism of Action
Vadadustat inhibits the activity of prolyl hydroxylase enzymes, which are responsible for the degradation of hypoxia-inducible factor (HIF) under normal oxygen conditions. By inhibiting these enzymes, Vadadustat stabilizes HIF, allowing it to accumulate and activate the transcription of genes involved in erythropoiesis, iron metabolism, and oxygen homeostasis. This results in increased production of erythropoietin, a hormone that stimulates the production of red blood cells in the bone marrow.
Clinical Use
Vadadustat is indicated for the treatment of anemia due to chronic kidney disease in adult patients. Anemia is a common complication of CKD, often resulting from reduced erythropoietin production by the kidneys. By increasing endogenous erythropoietin levels, Vadadustat helps to alleviate anemia and reduce the need for exogenous erythropoietin-stimulating agents (ESAs).
Administration and Dosage
Vadadustat is administered orally, and the dosage is typically adjusted based on the patient's hemoglobin levels and response to treatment. It is important to monitor hemoglobin levels regularly to avoid excessive erythropoiesis and potential complications such as hypertension or thromboembolic events.
Side Effects
Common side effects of Vadadustat include nausea, diarrhea, hypertension, and headache. As with other treatments for anemia, there is a risk of cardiovascular events, and patients should be monitored for signs of thrombosis or hypertension.
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Contributors: Prab R. Tumpati, MD