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Anemia in ESRD

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https://www.readbyqxmd.com/read/29151105/eryptosis-the-neglected-cause-of-anemia-in-end-stage-renal-disease
#1
Florian Lang, Rosi Bissinger, Majed Abed, Ferruh Artunc
End stage renal disease (ESRD) invariably leads to anemia which has been mainly attributed to compromised release of erythropoietin from the defective kidneys with subsequent impairment of erythropoiesis. However, erythropoietin replacement only partially reverses anemia pointing to the involvement of additional mechanisms. As shown more recently, anemia of ESRD is indeed in large part a result of accelerated erythrocyte loss due to suicidal erythrocyte death or eryptosis, characterized by cell shrinkage and cell membrane scrambling with phosphatidylserine translocation to the cell surface...
October 23, 2017: Kidney & Blood Pressure Research
https://www.readbyqxmd.com/read/29150415/-initiating-hemodialysis-in-morocco-impact-of-late-referral
#2
Abdelaali Bahadi, Mohammed Reda El Farouki, Yassir Zajjari, Driss El Kabbaj
INTRODUCTION: End-stage renal disease (ESRD) is a major public health concern in Morocco with an incidence in constant progression according to MAGREDIAL "Morocco Dialysis Registry". Patients are often sent late to nephrologists, which is a source of complications recognized in several countries. For these reasons, we tried to evaluate, in our context, the prevalence and factors of this late referral (LR). METHODS: This is a retrospective study which included all patients initiating hemodialysis between January 2007 and December 2015...
November 14, 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/29045980/-anti-neutrophil-cytoplasmic-antibodies-associated-vasculitis-with-lung-hemorrhage-in-the-patient-on-maintenance-haemodialysis-a-case-report
#3
J X Ding, M Wang
Anti-neutrophil cytoplasmic antibodies (ANCA)-associated vasculitis (AAV) is usually a multisystem disorder, and pulmonary renal syndrome is a common presentation. Patients with AAV are less likely to experience relapse when they progress to end-stage renal disease (ESRD). We report a rare case of diffuse alveolar hemorrhage (DAH) in relapsing AAV after eight years of haemodialysis. A 58-year-old woman was admitted to our hospital with the chief complaints of dyspnea and hemoptysis accompanied by anemia, fever, fatigue, and weight loss...
October 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28869934/typical-hemodialysis-in-india-a-case-report
#4
Georgi Abraham, Madhusudan Vijayan, Milly Mathew
We report here a typical case of a patient on hemodialysis (HD) for end-stage renal disease (ESRD) in India that highlights some of the management issues encountered in a country with an enormous burden of ESRD and major challenges of underdialysis and management of comorbidities. The patient, a 42-year-old multiparous woman with chronic kidney disease (CKD) stage V, type 2 diabetes mellitus, and hypertension is a homemaker from a middle-class family, living in a large city, with no family history of CKD. From May 2013 to December 2016, she has been receiving twice-weekly maintenance HD for 4 h (intermittent HD); access was via an internal jugular line initially and then via a left brachiocephalic arteriovenous fistula (AVF) from late June 2013...
2017: Blood Purification
https://www.readbyqxmd.com/read/28854342/short-term-effects-of-hemodiafiltration-versus-conventional-hemodialysis-on-erythrocyte-performance
#5
Hara T Georgatzakou, Vassilis L Tzounakas, Anastasios G Kriebardis, Athanassios D Velentzas, Apostolos C Kokkalis, Marianna H Antonelou, Issidora S Papassideri
Hemodiafiltration (HDF) is a renal replacement therapy which is based on the principles of diffusion and convection for the elimination of uremic toxins. A significant and increasing number of end stage renal disease (ESRD) patients are treated with HDF, even in the absence of definite and conclusive survival and anemia treatment data. However, its effects on red blood cell (RBC) physiological features have not been examined in depth. In this study, ESRD patients under regular HDF or conventional hemodialysis (cHD) treatment were examined for RBC-related parameters, including anemia, hemolysis, cell shape, redox status, removal signaling, membrane protein composition and microvesiculation, in repeated paired measurements accomplished before and right after each dialysis session...
August 30, 2017: Canadian Journal of Physiology and Pharmacology
https://www.readbyqxmd.com/read/28750609/hemodialysis-patients-preferences-for-the-management-of-anemia
#6
Brett Hauber, John Caloyeras, Joshua Posner, Deborah Brommage, Spiros Tzivelekis, Allan Pollock
BACKGROUND: Patient engagement in end-stage renal disease (ESRD) is expected to result in a more patient-centered approach to care that aligns with patients' values, preferences, and goals for treatment. Nevertheless, no previous studies of which we are aware have evaluated patients' benefit-risk preferences for the management of anemia associated with ESRD. The primary objective of this study was to quantify the tradeoffs patients are willing to make between cardiovascular risks associated with some anemia medicines and red blood cell (RBC) transfusions...
July 28, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28699885/does-helicobacter-pylori-infection-play-a-role-in-iron-deficiency-anemia-in-hemodialysis-patients
#7
Hisham El-Said, Aber Halim Baki Attallah, Zainab A Ali-Eldin
BACKGROUND: Among the disorders that may affect patients with end-stage renal disease (ESRD), anemia is the most responsive to treatment; any reversible cause should be identified, and the most common reversible cause is iron deficiency. We investigated the relationship between <italic>Helicobacter pylori</italic> infection and iron deficiency anemia in a hemodialysis population. MATERIALS AND METHODS: This cross-sectional study included 90 adult patients with ESRD on maintenance hemodialysis...
October 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28697735/v-j-combinations-of-t-cell-receptor-predict-responses-to-erythropoietin-in-end-stage-renal-disease-patients
#8
Henry Sung-Ching Wong, Che-Mai Chang, Chih-Chin Kao, Yu-Wen Hsu, Xiao Liu, Wen-Chang Chang, Mai-Szu Wu, Wei-Chiao Chang
BACKGROUND: Anemia is common among end-stage renal disease (ESRD) patients who undergone hemodialysis. The total reduction of red blood cell (RBC) count is associated with poor prognosis in these patients. Although erythropoietin (EPO) has been used as an effective treatment for ESRD patients with anemia, a large number of patients still present poor responses to EPO treatment. METHODS: We measured T-cell receptor sequencing profiles, including length of complementarity-deteremining region 3 (CDR3), intra- and inter-group (EPO resistant vs...
July 11, 2017: Journal of Biomedical Science
https://www.readbyqxmd.com/read/28600471/asymmetric-dimethylarginine-contributes-to-the-impaired-response-to-erythropoietin-in-ckd-anemia
#9
Miyuki Yokoro, Yosuke Nakayama, Sho-Ichi Yamagishi, Ryotaro Ando, Miki Sugiyama, Sakuya Ito, Junko Yano, Kensei Taguchi, Yusuke Kaida, Daisuke Saigusa, Masumi Kimoto, Takaaki Abe, Seiji Ueda, Kei Fukami
Erythropoietin-resistant anemia is associated with adverse cardiovascular events in patients with ESRD, but the underlying mechanism remains unclear. Here, we evaluated the role of the endogenous nitric oxide synthase inhibitor asymmetric dimethylarginine (ADMA). In 54 patients with advanced CKD, erythrocyte but not plasma ADMA levels independently associated with low hemoglobin values, although levels of both types of ADMA were elevated compared with those in healthy volunteers. Furthermore, erythrocyte ADMA level associated with the erythropoietin resistance index in patients receiving a weekly injected dose of erythropoiesis-stimulating agents standardized for hemoglobin levels and body weight, whereas it correlated with the erythropoietin demand index (plasma erythropoietin units divided by the hemoglobin value) in patients not receiving erythropoiesis-stimulating agents...
September 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28599901/esrd-after-heart-failure-myocardial-infarction-or-stroke-in-type%C3%A2-2-diabetic-patients-with-ckd
#10
David M Charytan, Scott D Solomon, Peter Ivanovich, Giuseppe Remuzzi, Mark E Cooper, Janet B McGill, Hans-Henrik Parving, Patrick Parfrey, Ajay K Singh, Emmanuel A Burdmann, Andrew S Levey, Dick de Zeeuw, Kai-Uwe Eckardt, John J V McMurray, Brian Claggett, Eldrin F Lewis, Marc A Pfeffer
BACKGROUND: How cardiovascular (CV) events affect progression to end-stage renal disease (ESRD), particularly in the setting of type 2 diabetes, remains uncertain. STUDY DESIGN: Observational study. SETTING & PARTICIPANTS: 4,022 patients with type 2 diabetes, anemia, and chronic kidney disease from the Trial to Reduce Cardiovascular Events With Aranesp Therapy (TREAT). PREDICTOR: Postrandomization CV events. OUTCOMES: ESRD (defined as initiation of dialysis for >30 days, kidney transplantation, or refusal or nonavailability of renal replacement therapy) and post-ESRD mortality within 30 days and during overall follow-up after an intercurrent CV event...
October 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28529812/diabetic-muscle-infarction-masquerading-as-necrotizing-fasciitis
#11
Kalyana C Janga, Ankur Sinha, Perry Wengrofsky, Phone Oo, Sheldon Greenberg, Regina Tarkovsky, Kavita Sharma
A 43-year-old male patient with past medical history of diabetes mellitus (DM), end stage renal disease (ESRD) on hemodialysis (HD), congestive heart failure (CHF), obstructive sleep apnea (OSA), and chronic anemia presented with complaints of left thigh pain. A computerized tomogram (CT) of the thigh revealed evidence of edema with no evidence of a focal collection or gas formation noted. The patient's clinical symptoms persisted and he underwent magnetic resonance imaging (MRI) of his thigh which was reported to show small areas of muscle necrosis with fluid collection...
2017: Case Reports in Nephrology
https://www.readbyqxmd.com/read/28497088/pulmonary-hypertension-among-patients-undergoing-hemodialysis
#12
Fatemeh Hayati, Seyed Seifollah Beladi Mousavi, Seyed Majid Mousavi Movahed, Maryam Mofrad Bushehri
Introduction: The epidemiology of pulmonary hypertension (PHT) among long-term hemodialysis patients has been described in relatively small studies in Iran. Objectives: The purpose of this study was to evaluate the prevalence of PHT and its relationship among end-stage renal disease (ESRD) patients undergoing long-term hemodialysis (HD). Patients and Methods: In a cross-sectional study, patients with ESRD treated with HD for at least 3 months in the Imam hospital enrolled for the study. PHT was defined as an estimated systolic pulmonary artery pressure (PAP) equal to or higher than 25 mm Hg using echocardiograms performed by cardiologist...
2017: Journal of Renal Injury Prevention
https://www.readbyqxmd.com/read/28487874/administration-of-pentoxifylline-to-improve-anemia-of-hemodialysis-patients
#13
Heshmatolah Shahbazian, Ali Ghorbani, Azita Zafar-Mohtashami, Abdolreza Balali, Armaghan AleAli, Gholam Reza Lashkarara
Introduction: One of the most important causes of erythropoietin-resistant anemia in end-stage renal disease (ESRD) patients is increased levels of inflammatory cytokines. Objectives: In this study pentoxifylline, an anti-inflammatory and anti-cytokine drug, with no significant side effects was used to manage anemia in ESRD patients. Patients and Methods: Thirty-nine ESRD patients with erythropoietin-resistant anemia were assigned to two groups, the treatment and the control groups. In treatment group, 19 patients received erythropoietin, venofer and pentoxifylline for 6 months...
2017: Journal of Renal Injury Prevention
https://www.readbyqxmd.com/read/28467997/treating-hepatitis-c-in-patients-with-renal-failure
#14
REVIEW
Sabela Lens, Sergio Rodriguez-Tajes, Laura-Patricia Llovet, Francisco Maduell, Maria-Carlota Londoño
BACKGROUND: There is a strong relationship between hepatitis C virus (HCV) infection and the kidney. Approximately 10-16% of the patients with HCV infection develop renal disease, and the prevalence of HCV infection in patients with renal dysfunction is higher than that of the general population (9.5 vs. 1.6%). Moreover, HCV-positive patients on hemodialysis (HD) have higher mortality rates as compared to HCV-negative patients also on HD, not only due to liver-related complications but also owing to cardiovascular disease...
2017: Digestive Diseases
https://www.readbyqxmd.com/read/28386819/disease-burden-early-discontinuation-and-healthcare-costs-in-hepatitis-c-patients-with-and-without-chronic-kidney-disease-treated-with-interferon-free-direct-acting-antiviral-regimens
#15
Amy Puenpatom, Michael Hull, Jeffrey McPheeters, Kay Schwebke
BACKGROUND: Hepatitis C virus (HCV) is a risk factor for chronic kidney disease (CKD) and end-stage renal disease (ESRD). Direct-acting antiviral agents (DAAs) have improved HCV management in CKD patients, however real-world clinical practice data are limited. OBJECTIVE: This study examined the prevalence of CKD among HCV patients receiving oral DAAs in a real-world setting. Comorbidities, early discontinuation rates, and healthcare costs were compared between patients with and without CKD...
July 2017: Clinical Drug Investigation
https://www.readbyqxmd.com/read/28370957/safety-of-intravenous-iron-in-hemodialysis-patients
#16
REVIEW
Xiaojuan Li, Abhijit V Kshirsagar, M Alan Brookhart
Among end-stage renal disease patients maintained by hemodialysis, anemia has been managed primarily through erythropoiesis-stimulating agents (ESAs) and intravenous (IV) iron. Following concerns about the cardiovascular (CV) safety of ESAs and changes in the reimbursement policies in Medicare's ESRD program, the use of IV iron has increased. IV iron supplementation promotes hemoglobin production and reduces ESA requirements, yet there exists relatively little evidence on the long-term safety of iron supplementation in hemodialysis patients...
June 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28284384/autosomal-dominant-tubulointerstitial-kidney-disease
#17
REVIEW
Anthony J Bleyer, Kendrah Kidd, Martina Živná, Stanislav Kmoch
There are 3 major forms of autosomal dominant tubulointerstitial kidney disease (ADTKD): ADTKD due to UMOD mutations, MUC1 mutations, and mutations in the REN gene encoding renin. Lack of knowledge about these conditions contributes to frequent nondiagnosis, but with even limited knowledge, nephrologists can easily obtain a diagnosis and improve patient care. There are 3 cardinal features of these disorders: (1) the conditions are inherited in an autosomal dominant manner and should be considered whenever both a parent and child suffer from kidney disease; the presence of even more affected family members provides further support...
March 2017: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/28282547/study-of-association-between-interleukin-17-and-interferon-gamma-and-recombinant-human-erythropoietin-dose-in-patients-undergoing-peritoneal-dialysis
#18
Wander Valadares de Oliveira, Roberta Carvalho de Figueiredo, Adriano Sabino de Paula, Sylvia Dias Turani, Marina Souza Silva Velloso, Melina Barros Pinheiro, Karina Braga Gomes, Maria Aparecida Silva Marinho, Sérgio Wyton Lima Pinto, Danyelle Romana Alves Rios
BACKGROUND: A common complication in patients undergoing peritoneal dialysis (PD) is a chronic inflammatory state and anemia that can be treating by recombinant human erythropoietin (rHuEPO). Higher required dose of rHuEPO could be expected in patients with higher cytokine levels. Additionally, it is known that peritoneal inflammation can be correlated with systemic inflammation and this could contribute to the compromised rHuEPO required dose in anemic patients with end stage renal disease (ESRD)...
August 2017: Cytokine
https://www.readbyqxmd.com/read/28281281/hemodialysis-disparities-in-african-americans-the-deeply-integrated-concept-of-race-in-the-social-fabric-of-our-society
#19
REVIEW
Keith C Norris, Sandra F Williams, Connie M Rhee, Susanne B Nicholas, Csaba P Kovesdy, Kamyar Kalantar-Zadeh, L Ebony Boulware
End-stage renal disease (ESRD) is one of the starkest examples of racial/ethnic disparities in health. Racial/ethnic minorities are 1.5 to nearly 4 times more likely than their non-Hispanic White counterparts to require renal replacement therapy (RRT), with African Americans suffering from the highest rates of ESRD. Despite improvements over the last 25 years, substantial racial differences are persistent in dialysis quality measures such as RRT modality options, dialysis adequacy, anemia, mineral and bone disease, vascular access, and pre-ESRD care...
May 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28161839/osteoprotegerin-and-uremic-osteoporosis-in-chronic-hemodialysis-patients
#20
Diana Moldovan, Crina Rusu, Alina Potra, Ioan Moldovan, Ioan Mihai Patiu, Mirela Gherman-Caprioara, Ina Maria Kacso
INTRODUCTION: Osteoprotegerin (OPG) is a powerful inhibitor of osteoclast activity, and it plays an important role in bone metabolism. In hemodialysis (HD) patients, the relationship between OPG and bone mineral density (BMD) is important, but remains unclear yet. The study objective was to assess the OPG role related to uremic osteoporosis in HD patients. METHODS: This cross-sectional study has been realized on a cohort of 63 chronic HD patients. INCLUSION CRITERIA: elderly prevalent HD patients with an age over 55 years old...
May 2017: International Urology and Nephrology
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