Received: 21 April 2018 | Revised: 18 June 2018 | Accepted: 6 July 2018 DOI: 10.1002/med.21527 REVIEW ARTICLE Erythropoiesis and chronic kidney disease–related anemia: From physiology to new therapeutic advancements Valeria Cernaro1 | Giuseppe Coppolino2 | Luca Visconti1 | Laura Rivoli3 | Antonio Lacquaniti1 | Domenico Santoro1 | Antoine Buemi4 | Saverio Loddo5 | Michele Buemi1 1Chair of Nephrology, Department of Clinical and Experimental Medicine, University of Abstract Messina, Messina, Italy Erythropoiesis is triggered by hypoxia and is strictly 2Nephrology and Dialysis Unit, Department of regulated by hormones, growth factors, cytokines, and Internal Medicine, “Pugliese‐Ciaccio” Hospital of Catanzaro, Catanzaro, Italy vitamins to ensure an adequate oxygen delivery to all 3Unit of Nephrology, Department of Internal body cells. Abnormalities in one or more of these factors Medicine, Chivasso Hospital, Turin, Italy may induce different kinds of anemia requiring different 4Surgery and Abdominal Transplantation Division, Cliniques Universitaires Saint‐Luc, treatments. A key player in red blood cell production is Université Catholique De Louvain, Brussels, erythropoietin. It is a glycoprotein hormone, mainly Belgium 5Department of Clinical and Experimental produced by the kidneys, that promotes erythroid Medicine, University of Messina, Messina, progenitor cell survival and differentiation in the bone Italy marrow and regulates iron metabolism. A deficit in Correspondence erythropoietin synthesis is the main cause of the normo- Valeria Cernaro, Chair of Nephrology, Department of Clinical and Experimental chromic normocytic anemia frequently observed in pa- Medicine, University of Messina, Via tients with progressive chronic kidney disease. The Consolare Valeria n. 1, Messina 98124, Italy. Email:
[email protected] present review summarizes the most recent findings about each step of the erythropoietic process, going from the renal oxygen sensing system to the cascade of events induced by erythropoietin through its own receptor in the bone marrow.