The Mechanisms and Role of HIF-PHIs in Patients with CKD and Anemia: Advances in the Therapeutic Landscape – Twitter chat #1




Supported by an educational grant from AstraZeneca Pharmaceuticals LP in collaboration with FibroGen.


Patients with CKD and anemia experience substantially increased burdens to morbidity and mortality. The use of erythropoiesis-stimulating agent (ESA) and iron supplementation are mainstays of therapy, yet ESA has been associated with increased cardiovascular adverse events. Furthermore, some patients are resistant to ESA, resulting in higher doses to reach target hemoglobin levels and increasing the risk of adverse events. Increased understanding of hypoxia-inducible factors (HIFs) have led to the development of novel therapies, HIF-PHIs, that work by simulating hypoxia in cells, thereby stimulating EPO synthesis and improving iron metabolism and mobilization through reduced hepcidin levels. Three HIF-PHIs (i.e. roxadustat, vadadustat, and daprodustat) are currently undergoing or have recently completed late-stage development. To be best prepared to incorporate these agents into clinical practice once FDA-approved, nephrologists must be educated on the burdens associated with anemia in CKD, pathophysiological mechanisms involved in CKD-related anemia, and recent outcomes from clinical trials evaluating HIF-PHIs in patients with CKD. This educational activity will address these knowledge gaps among nephrologists, and application of this knowledge will improve outcomes for patients with anemia and CKD.


Martha Gulati, MD, MS, FACC, FAHA, FASPC
Professor of Medicine, Chief of Cardiology
University of Arizona
Phoenix, AZ


Daniel Coyne, MD
Professor of Medicine (Division of Nephrology)
Director, Chromalloy American Kidney Center
Director, Medicine Multispecialty Clinics
Washington University School of Medicine
St Louis, Missouri


Release date: February 25, 2021
Expiration date: February 25, 2022
Estimated time to complete activity: 1.0 hour(s)



This educational activity has been designed to meet the needs of nephrologists and other nephrology healthcare professionals, including physician assistants, nurse practitioners, and patients.


Upon completion of this educational activity, participants should be able to:

  • Discuss the prevalence and burdens of anemia associated with CKD, including factors contributing to underdiagnosis and undertreatment
  • Explain the pathophysiologic processes underlying anemia associated with CKD, including potential therapeutic targets

There are no fees for participating and receiving CME credit for this activity. During the period of February 25, 2021 – February 25, 2022 participants must:

  • Read the learning objectives and faculty disclosures
  • Complete the pretest
  • Study the educational activity
  • Complete the posttest and the evaluation form

A statement of credit will be issued only upon receipt of a completed activity evaluation form and a completed posttest with a score of 100%.




Physician Continuing Education

 Accreditation Statement
Integrity Continuing Education is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.


Integrity Continuing Education designates this enduring activity for a maximum of 1 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.


For information about ACCME accreditation of this activity, please contact Integrity Continuing Education at (855) 835-4004 or


Integrity Continuing Education requires instructors, planners, managers, and other individuals who are in a position to control the content of this activity to disclose any real or apparent conflict of interest they may have as related to the content of this activity. All identified conflicts of interest are thoroughly vetted by Integrity Continuing Education for fair balance, scientific objectivity of studies mentioned in the materials or used as the basis for content, and appropriateness of patient care recommendations.

The following faculty/planners reported the financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of these CME activities:

Martha Gulati, MD, MS, FACC, FAHA, FASPC has nothing to disclose.

Daniel W. Coyne, MD
Consulting Fees: Fresenius/Vifor; GSK; Reata; Astra Zeneca; Otsuka; Ardelyx
Expert Witness: Vifor, Patent Litigation

The Integrity Continuing Education, Inc planners and managers have nothing to disclose.


This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. Integrity Continuing Education, Inc does not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of any organization associated with this activity. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.


When you participate in an online educational activity sponsored by Integrity Continuing Education, Inc, you will be asked for your name, degree(s), affiliation(s), street address, telephone number and…(continued)


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The information provided at this activity is for continuing education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient’s medical condition.


Provided by Integrity Continuing Education, Inc.


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