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Anemia in ESRD

Salahuddin Khan, Tariq Hussain, Najma Salahuddin, Salahuddin Mehreen
AIM: The basic aim of this study was to discover the association of End Stage Renal Disease (ESRD) with various risk factors. End Stage Renal Failure is the last stage of the chronic renal failure in which kidneys become completely fail to function. MATERIALS AND METHODS: The data were collected from the patients of renal diseases from three major hospitals in Peshawar, Pakistan. Odds ratio analysis was performed to examine the relationship of ESRD (a binary response variable) with various risk factors: Gender, Diabetic, Hypertension, Glomerulonephritis, Obstructive Nephropathy, Polycystic kidney disease, Myeloma, SLE Nephritis, Heredity, Hepatitis, Excess use of Drugs, heart problem and Anemia...
September 15, 2016: Open Access Macedonian Journal of Medical Sciences
Finnian R Mc Causland, Brian Claggett, Emmanuel A Burdmann, Kai-Uwe Eckardt, Reshma Kewalramani, Andrew S Levey, John J V McMurray, Patrick Parfrey, Giuseppe Remuzzi, Ajay K Singh, Scott D Solomon, Robert D Toto, Marc A Pfeffer
BACKGROUND: To better understand a potential association of elevated C-reactive protein (CRP) level with progression of chronic kidney disease (CKD), we examined the relationship of CRP level with the development of end-stage renal disease (ESRD) in the Trial to Reduce Cardiovascular Events With Aranesp Therapy (TREAT). STUDY DESIGN: Post hoc analysis of a randomized controlled trial. SETTING & PARTICIPANTS: 4,038 patients with type 2 diabetes, CKD, and anemia in TREAT...
September 16, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Scott Sibbel, Bradley J Maroni, Steven M Brunelli
Residence at higher altitude has been associated with improved anemia parameters and lower mortality rates among end-stage renal disease (ESRD) patients. However, these associations were observed prior to the 2011 shift in erythropoiesis-stimulating agent (ESA) dosing. To determine the impact of altitude on contemporary ESRD patients, a retrospective observational analysis was conducted in which patients were ascribed to one of four altitude categories as of 1 Jan 2012 and outcomes were assessed during 2012...
September 19, 2016: Journal of Nephrology
Teresa Kurzawa, Aleksander Owczarek, Joanna K Strzelczyk, Karolina Gołąbek, Andrzej Wiczkowski
BACKGROUND: Chronic renal disease constitutes a serious worldwide clinical problem. An important issue arising early during the treatment of renal failure is anemia. Patients in the end-stage of renal disease chronically treated with hemodialysis frequently suffer from anemia with iron deficiency. OBJECTIVES: The aim of the study was to evaluate the usefulness of determining the reticulocyte hemoglobin content and serum concentration of soluble transferrin receptor in the detection of anemia caused by iron deficiency in comparison with the classic markers of iron circulation in serum in chronic dialysis patients with ESRD...
May 2016: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
Eric Seibert, Anja Richter, Martin K Kuhlmann, Suxin Wang, Nathan W Levin, Peter Kotanko, Garry J Handelman
Introduction The achievement of erythropoiesis in hemodialysis (HD) patients is typically managed with erythropoiesis-stimulating-agents (ESA's) and intravenous iron (IV-iron). Using this treatment strategy, HD patients frequently show an elevated fraction of red blood cells (RBC) with hemoglobin (Hb) content per cell that is below the normal range, called hypochromic RBC. The low Hb content per RBC is the result of the clinical challenge of providing sufficient iron content to the bone marrow during erythropoiesis...
September 12, 2016: Hemodialysis International
Ranganathan Srinivasan, Ibel C Fredy, Santosh Chandrashekar, Janarthanan Saravanan, Guru Prasad Mohanta, Prabal K Manna
BACKGROUND AND OBJECTIVE: Currently there is an inadequate data regarding effective management of anemia in chronic kidney disease (CKD) patients who are on dialysis. In CKD patients' anemia mainly develops from decreased renal synthesis of erythropoietin (EPO) and iron deficiency. Our current study focused to effective management of anemia in CKD patients'. STUDY DESIGN: Prospective observational case series study. METHODS: Eligible patients were assigned to three study groups according to initial hemoglobin level i...
August 2016: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
Émilie René, Hind H Lazrak, Louis-Philippe Laurin, Naoual Elftouh, Michel Vallée, Jean-Philippe Lafrance
BACKGROUND: Erythropoiesis-stimulating agents (ESAs) are the cornerstone of the treatment for anemia in end-stage renal disease (ESRD) patients. Although a correlation has been established between ESAs and increased tumor growth among patients with cancer-related anemia, an association with a higher incidence of cancer among chronic dialysis patients remains relatively unclear. METHODS: We completed a nested case-control study in a cohort of 4574 patients who began chronic dialysis treatment between 1 January 2001 and 31 December 2007 in Quebec, Canada, utilizing dialysis registry and administrative databases exclusively to extract our data...
July 21, 2016: Nephrology, Dialysis, Transplantation
Lauren B Beach, Marcus Wild, Gowri Ramachandran, H Omer Ikizler, Kerri L Cavanaugh
BACKGROUND: Erythropoiesis-stimulating agents (ESAs) are commonly used for the treatment of anemia due to chronic kidney disease (CKD) and end stage renal disease (ESRD). Patients often lack an understanding of the potential risks and benefits of ESAs, despite government mandated education on this topic. Decision aids are tools commonly used to discuss important information in health care settings. To address this knowledge gap, we designed this study to evaluate the effectiveness of a novel ESA decision aid at promoting informed shared decision making (ISDM) between patients and providers related to ESA use for CKD- and ESRD-related anemia...
2016: BMC Nephrology
Ebru Gok Oguz, Guner Karaveli Gursoy, Ozlem Yayar, Tolga Yildirim, Tolga Cimen, Cengiz Bulut, Barıs Eser, Basol Canbakan, Ekrem Yeter, M Deniz Ayli
INTRODUCTION: Left ventricular hypertrophy (LVH) is one of the most common cardiac abnormalities in patients with end stage renal disease (ESRD). Hypertension, diabetes, increased body mass index, gender, age, anemia, and hyperparathyroidism have been described as risk factors for LVH in patients on dialysis. However, there may be other risk factors which have not been described yet. Recent studies show that renalase is associated with cardiovascular events. The aim of this study was to reveal the relation between renalase, LVH in patients under hemodialysis (HD) treatment...
September 2016: Renal Failure
Yung Ly Kim, Hyunwook Kim, Young Eun Kwon, Dong Ryeol Ryu, Mi Jung Lee, Kyung Sook Park, Han Jak Ryu, Jung Tak Park, Hyung Jung Oh, Seung Hyeok Han, Tae Hyun Yoo, Shin Wook Kang
PURPOSE: Despite new treatment strategies, anemia remains the most prevalent complication in patients with end-stage renal disease (ESRD). We investigated whether 25-hydroxyvitamin D [25(OH)D3] deficiency was associated with anemia in ESRD patients. MATERIALS AND METHODS: We reviewed the medical records of 410 ESRD patients who had undergone renal transplantation (RTx) at Yonsei University Health System and who had 25(OH)D3 levels measured at the time of RTx. Patients were divided into two groups based on baseline 25(OH)D3 concentrations: group 1, 25(OH)D3 levels <10 ng/mL; and group 2, 25(OH)D3 levels ≥10 ng/mL...
September 2016: Yonsei Medical Journal
Nina Battelino, Karin Writzl, Nevenka Bratanič, Melita D Irving, Gregor Novljan
Hajdu-Cheney syndrome (HJCYS) is a rare, autosomal dominant, skeletal disorder caused by mutations in the NOTCH2 signaling pathway for which genetic testing has recently become available. Renal abnormalities are associated in at least 10% of cases. We present an 8-year-old Caucasian boy, born with multiple dysmorphic features consistent with HJCYS. Imaging of the urinary tract revealed bilateral cystic dysplastic kidneys with associated vesicoureteral reflux. Renal function has been impaired since birth and deteriorated progressively to end-stage renal disease (ESRD) by the age of two and a half years, when peritoneal dialysis was initiated and only recently renal transplantation was performed...
June 2016: Therapeutic Apheresis and Dialysis
Prasert Thanakitcharu, Boonthum Jirajan
BACKGROUND: Erythropoiesis-stimulating agent (ESA) treatment is the optimal therapy for anemia in end-stage renal disease (ESRD) patients receiving hemodialysis. During treatment with ESA, the level of hemoglobin usually fluctuates widely; this phenomenon is known as "hemoglobin cycling" and may be associated with higher rates of mortality. OBJECTIVE: To estimate the prevalence of hemoglobin cycling in Thai ESRD patients treated with chronic maintenance hemodialysis and ESA, to assess its clinical impact on patient outcomes, and to identify the associated risk factors for hemoglobin cycling occurrence...
February 2016: Journal of the Medical Association of Thailand, Chotmaihet Thangphaet
James B Wetmore, Spiros Tzivelekis, Allan J Collins, Craig A Solid
BACKGROUND: The 2011 expanded Prospective Payment System (PPS) and contemporaneous Food and Drug Administration label revision for erythropoiesis-stimulating agents (ESAs) were associated with changes in ESA use and mean hemoglobin levels among patients receiving maintenance dialysis. We aimed to investigate whether these changes coincided with increased red blood cell transfusions or changes to Medicare-incurred costs or sites of anemia management care in the period immediately before and after the introduction of the PPS, 2009-2011...
2016: BMC Nephrology
Samar K M Khalil, H A Amer, Adel M El Behairy, Mohamad Warda
Inflammation and oxidative stress are two faces of one coin in end stage renal disease patients (ESRD) on maintenance hemodialysis. Their interconnection induces anemia complicated with erythropoietin hyporesponsiveness. The biochemical bases behind the resistance to erythropoietin therapy with frequent hemoglobinemia, oxidative stress and iron status have not been fully understood. Here two equal groups (40 patients each) of responders and non-responders to recombinant human erythropoietin therapy (higher than 300 IU/kg/wk of epoetin) were investigated...
May 2016: Journal of Advanced Research
Jumana H Albaramki, Iyad A Al-Ammouri, Kamal F Akl
Adult patients with chronic kidney disease are at risk of major neurologic and cardiac complications. The purpose of this study is to review the neurological and cardiac complications in children with end-stage renal disease (ESRD). A retrospective review of medical records of children with ESRD at Jordan University Hospital was performed. All neurological and cardiac events were recorded and analyzed. Data of a total of 68 children with ESRD presenting between 2002 and 2013 were reviewed. Neurological complications occurred in 32...
May 2016: Saudi Journal of Kidney Diseases and Transplantation
José Luis Lepe-Zúñiga, Pedro Morales-Molina, Gabriela Alejandra García-Nandayapa
BACKGROUND: Patients with End Stage Renal Disease (ESRD), defined as those in Stage 5 of the Kidney Disease Outcome Quality Initiative (KDOQI) classification, have a number of acquired immune deficiencies secondary to the uremic stage, among them lymphopenia. In the present report, we retrospectively characterized the peripheral blood lymphocyte counts in a group of patients with ESRD and we related lymphopenia to their biochemical parameters and to the presence or absence of infections...
July 2016: Revista Médica del Instituto Mexicano del Seguro Social
Xiao Lu Jiang, Ji Qiu Wen, Long Jiang Zhang, Gang Zheng, Xue Li, Zhe Zhang, Ya Liu, Li Juan Zheng, Long Wu, Hui Juan Chen, Xiang Kong, Song Luo, Guang Ming Lu, Xue Man Ji, Zong Jun Zhang
We used arterial-spin labeling (ASL) MR imaging, a non-invasive technique to evaluate cerebral blood flow (CBF) changes in patients with end-stage renal disease (ESRD) undergoing peritoneal dialysis (PD) and hemodialysis (HD), and nondialysis ESRD patients compared with healthy cohort. Ninety seven ESRD patients including 32 PD patients (20 male, 12 female; mean age 33 ± 8 years), 33 HD patients (22 male, 11 female; mean age 33 ± 8 years) and 32 nondialysis patients (20 male, 12 female; mean age 35 ± 7 years) and 31 age- and gender-matched healthy controls (20 male, 11 female; mean age 32 ± 8 years) were included in this study...
August 2016: Metabolic Brain Disease
Shaoshan Liang, Weibo Le, Dandan Liang, Hao Chen, Feng Xu, Huiping Chen, Zhihong Liu, Caihong Zeng
BACKGROUND: This study aimed to investigate renal outcomes and their predictors in biopsy-proven hypertensive nephrosclerosis (HN) patients and to compare clinico-pathological characteristics and prognoses between benign nephrosclerosis (BN) and malignant nephrosclerosis (MN) patients. METHODS: Data for biopsy-proven HN patients were retrospectively analyzed. Renal survival rates and relationships between clinico-pathological characteristics and outcomes were assessed...
2016: BMC Nephrology
Xiao Mei Li, Hao Chen Rui, Dan Dan Liang, Feng Xu, Shao Shan Liang, Xiao Dong Zhu, Xiang Hua Huang, Zhi Hong Liu, Cai Hong Zeng
To explore the clinicopathological characteristics and outcomes of light chain deposition disease (LCDD) in a Chinese population, we retrospectively studied the clinicopathological data, treatment, and outcomes of 48 patients with biopsy-proven LCDD from a single center. Among the patients, there were 29 males and 19 females, with an average age of 51 years. The patients presented with hypertension (79.2 %), edema (60.4 %), renal insufficiency (95.8 %), anemia (93.8 %), nephrotic proteinuria (≥3.0 g/24 h) (44...
May 2016: Annals of Hematology
Teresa Slomka, Emily S Lennon, Hina Akbar, Elvira O Gosmanova, Syamal K Bhattacharya, Carrie S Oliphant, Rami N Khouzam
Blockers of the renin-angiotensin-aldosterone system (RAAS), such as angiotensin-converting enzyme inhibitors and angiotensin receptor blockers are routinely used in patients with chronic kidney disease because of their cardiovascular (CV) and renoprotective effects. However, there are no uniform recommendations about RAAS blockers for CV protection in the end-stage renal disease (ESRD) population other than the preferred drug class for blood pressure control. This uncertainty stems from the fact that patients with ESRD were generally excluded from randomized controlled trials evaluating the cardioprotective benefits of RAAS blockers...
March 2016: American Journal of the Medical Sciences
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