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Anemia hemodialysis

Hafsa Chahdi, Mohamed Oukabli
Primary hyperoxaluria is a rare disease whose incidence is estimated at less than 1 cases/million inhabitants/year. This is a congenital abnormality of hepatic metabolism leading to an endogenous overproduction of oxalate with excess urinary excretion. We report the case of a 43-year-old patient, was followed to end-stage renal disease hemodialysis, consulting for anemic syndrome with mucocutaneous pallor. Laboratory tests found pancytopenia with aplastic anemia. Bone marrow was difficult to achieve, bringing medullary blood hyperdilué and uninterpretable ...
2018: Pan African Medical Journal
Alexandru Oanță, Veronica Iliescu, Smaranda Țărean
Half and half nails or Lindsay's nails were first mentioned by Bean (1) in 1964 and later described by Lindsay (2) in 1967 in patients with chronic kidney disease. They can occur in various diseases but also in healthy individuals. A 57-year-old patient with no significant pathological personal history consulted us for discoloration of all his nails on the fingers (Figure 1) and toes (Figure 2). The change in color occurred 17 years ago and had persisted since. The patient had no significant family history and denied a longer period of consumption of drugs, tobacco, or alcohol...
December 2017: Acta Dermatovenerologica Croatica: ADC
Adam E Gaweda, Alfred A Jacobs, George R Aronoff, Michael E Brier
BACKGROUND: Standard protocol-based approaches to erythropoiesis stimulating agent (ESA) dosing in anemia management of end-stage renal disease (ESRD) fail to address the inter-individual variability in patient's response to ESA. We conducted a single-center quality improvement project to investigate the long-term performance of a computer-designed dosing system. MATERIALS AND METHODS: The study was a retrospective case-control study with long-term follow-up. All hemodialysis patients who received treatment at University Kidney Center (Louisville, KY, USA) between September 1, 2009, and March 31, 2017, were included...
July 27, 2018: Clinical Nephrology
Yusuke Watanabe, Hirokazu Okada
BACKGROUND: In Japan, combined peritoneal dialysis (PD) and hemodialysis (HD) therapy is performed widely as an established modality of renal replacement therapy. This combination therapy is indicated for patients who cannot maintain adequate solute clearance using a standard PD prescription, or those who have uremic symptoms or a state of persistent fluid overload. A common treatment schedule for combined PD + HD therapy consists of 5 days of PD and one HD session per week. A 4- to 5-h HD session is performed with a high-flux membrane dialyzer...
2018: Contributions to Nephrology
Terumi Higuchi
BACKGROUND: Carnitine deficiency is a common condition in hemodialysis patients. There have been numerous reports on the efficacy of levocarnitine therapy in hemodialysis patients, including different views. Reported effects of levocarnitine are: (1) improvement of renal anemia, (2) improvement of cardiac functions, (3) effects on muscle spasm and asthenia, (4) anti-atherogenic effects, (5) anti-oxidant and anti-inflammatory effects, and (6) inhibitory effects on dialysis hypotension...
2018: Contributions to Nephrology
Takahiro Kuragano, Takeshi Nakanishi
Recent large clinical trials have reported that despite the maintenance of target hemoglobin (Hb) levels, higher doses of erythropoiesis-stimulating agents (ESAs) and/or iron preparations are significantly associated with higher risks of adverse events and death in maintenance hemodialysis (MHD) patients. Higher doses of ESAs have been demonstrated to result in a higher risk for cardiovascular disease due to elevated blood pressure or increased thrombogenicity. In addition, a high dose of iron might enhance inflammatory responses to infection and impair the phagocytic function of neutrophils...
2018: Contributions to Nephrology
Kazuhiko Tsuruya, Hisako Yoshida
BACKGROUND: There is an increasing prevalence of dementia associated with population aging, and anti-dementia measures have now become of increasing importance in Japan. Chronic kidney disease (CKD) is a risk factor for cognitive impairment. SUMMARY: We previously demonstrated that hemodialysis patients have a higher prevalence of brain atrophy, even at younger age, than the general population, and also demonstrated the association between frontal lobe atrophy and frequency of rapid decline in blood pressure during the hemodialysis session...
2018: Contributions to Nephrology
Hiroaki Io, Yusuke Suzuki
BACKGROUND: Currently, left ventricular (LV) hypertrophy and dysfunction are considered the strongest predictors of cardiovascular mortality in chronic kidney disease (CKD) patients. We investigated the factors associated with elevated LV mass index (LVMI) using echocardiography and assessed the strategies used to treat CKD (stages 1-5D) patients. SUMMARY: In study 1, we prospectively determined correlations among biochemical values, physical specimens, and LVMI using echocardiography in hemodialysis (HD) and peritoneal dialysis (PD) patients (stage 5D)...
2018: Contributions to Nephrology
Steven G Achinger, Juan Carlos Ayus
Cardiovascular mortality accounts for most deaths among hemodialysis patients and far exceeds the cardiovascular mortality rate of the general population. One important aspect of cardiovascular risk among dialysis patients is chronic inflammation. Iatrogenic sources of chronic inflammation in the form of failed renal allografts, old clotted arteriovenous grafts, and hemodialysis catheters play important, sometimes, unrecognized roles in this inflammatory state. There is ample observational evidence that these sources of inflammation are associated with hypoalbuminemia, erythropoetin-resistant anemia, and increased markers of chronic inflammation...
July 22, 2018: Seminars in Dialysis
Melissa Soohoo, Miklos Z Molnar, Akos Ujszaszi, Yoshitsugu Obi, Csaba P Kovesdy, Kamyar Kalantar-Zadeh, Elani Streja
Background: Red blood cell distribution width (RDW) is found to be associated with different types of anemia and has recently been studied as a prognostic marker of mortality in hemodialysis patients. However, the relationship of RDW with mortality and hospitalization rate in peritoneal dialysis (PD) patients is less known. Methods: Among 14 323 incident PD patients between 2007 and 2011 in the USA, we examined the relationship of baseline and time-varying RDW with the risk of mortality and time to first hospitalization using adjusted Cox models...
July 18, 2018: Nephrology, Dialysis, Transplantation
Giovanna Stoppa, Carmen D'Amore, Anita Conforti, Giuseppe Traversa, Mauro Venegoni, Maurizio Taglialatela, Roberto Leone
BACKGROUND: Erythropoiesis-stimulating agents (ESAs) are biological molecules approved for the treatment of anemia associated with chronic renal failure. Biosimilars were licensed for use in Europe in 2007. AIM: This study aimed to compare the safety profile of biosimilars with respect to the reference product in a nephrology setting. METHODS: A prospective study was conducted in four Italian regions between 1 October 2013 and 30 June 2015...
August 2018: BioDrugs: Clinical Immunotherapeutics, Biopharmaceuticals and Gene Therapy
Rachel Gavish, Salmas Watad, Nathalie Ben-Califa, Ori Jacob Goldberg, Orly Haskin, Miriam Davidovits, Gili Koren, Yafa Falush, Drorit Neumann, Irit Krause
BACKGROUND: Decreased production of erythropoietin (EPO) is a major cause of anemia associated with chronic kidney disease (CKD). Treatment with recombinant human EPO (rHuEPO) improves patients' quality of life and survival; however, there is a marked variability in response to rHuEPO. At present, no available laboratory test is capable of evaluating responsiveness to EPO treatment. The aim of the present study was to use an in vitro bioassay to estimate the effect of uremic environment on EPO-dependent erythroid cell proliferation...
July 20, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Goki Suda, Masayuki Kurosaki, Jun Itakura, Namiki Izumi, Yoshihito Uchida, Satoshi Mochida, Chitomi Hasebe, Masami Abe, Hiroaki Haga, Yoshiyuki Ueno, Ikuto Masakane, Kazumichi Abe, Atsushi Takahashi, Hiromasa Ohira, Ken Furuya, Masaru Baba, Yoshiya Yamamoto, Tomoe Kobayashi, Atsuhiko Kawakami, Kenichi Kumagai, Katsumi Terasita, Masatsugu Ohara, Naoki Kawagishi, Machiko Umemura, Masato Nakai, Takuya Sho, Mitsuteru Natsuizaka, Kenichi Morikawa, Koji Ogawa, Naoya Sakamoto
BACKGROUND: The prevalence of hepatitis C virus (HCV) infection in hemodialysis patients is high and results in a poor prognosis. Thus, safer and more effective treatment regimens are required. In this prospective multicenter study, we investigated the efficacy and safety of the novel HCV-NS5A-inhibitor, elbasvir, and protease inhibitor, grazoprevir in Japanese hemodialysis patients with genotype 1b HCV infection. METHODS: This study is registered at the UMIN Clinical Trials Registry as UMIN00002578...
July 17, 2018: Journal of Gastroenterology
Angelo Karaboyas, Hal Morgenstern, Ronald L Pisoni, Jarcy Zee, Raymond Vanholder, Stefan H Jacobson, Masaaki Inaba, Lisa C Loram, Friedrich K Port, Bruce M Robinson
Background: The Kidney Disease: Improving Global Outcomes guidelines have cautioned against administering intravenous (IV) iron to hemodialysis patients with high serum ferritin levels due to safety concerns, but prior research has shown that the association between high ferritin and mortality could be attributed to confounding by malnutrition and inflammation. Our goal was to better understand the ferritin-mortality association and relative influence of IV iron and inflammation in the USA, where ferritin levels have recently increased dramatically, and in Europe and Japan, where ferritin levels are lower and anemia management practices differ...
July 11, 2018: Nephrology, Dialysis, Transplantation
Michaela Kohlová, Célia Gomes Amorim, Alberto Araújo, Alice Santos-Silva, Petr Solich, Maria Conceição B S M Montenegro
End-stage renal disease is a growing health problem with increasing prevalence and high health care costs. Patients suffering from end-stage renal disease exhibit higher morbidity and mortality rates compared to the general population. These patients, who are treated using hemodialysis, typically suffer from anemia, inflammation, and oxidative stress. Inadequate dialyzer membrane biocompatibility exacerbates these negative side effects. Modifications of the composition of hemodialysis membranes have improved their biocompatibility and improve the patients' quality of life...
July 14, 2018: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
Raymond D Pratt, Sarah Grimberg, Joshua J Zaritsky, Bradley A Warady
BACKGROUND: Iron deficiency is a common cause of anemia in pediatric patients with hemodialysis-dependent chronic kidney disease (CKD-5HD). Ferric pyrophosphate citrate (FPC, Triferic®) donates iron directly to transferrin, bypassing the reticuloendothelial system and avoiding iron sequestration. Administration of FPC via dialysate or intravenously (IV) may provide a suitable therapeutic option to current IV iron preparations for these patients. METHODS: The pharmacokinetics and safety of FPC administered via dialysate and IV to patients aged < 6 years (n = 3), 6 to < 12 years (n = 4), and 12 to <18 years (n = 15) were investigated in a multicenter, open-label, two-period, single-dose study...
July 12, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Borut Cizman, Andy P Sykes, Gitanjali Paul, Steven Zeig, Alexander R Cobitz
Introduction: Hyporesponsiveness to recombinant human erythropoietin (rhEPO) is a major problem affecting some patients with chronic kidney disease (CKD), predominantly those on hemodialysis (HD). Daprodustat (GSK1278863) is a hypoxia-inducible factor prolyl hydroxylase inhibitor that is being investigated as a treatment for anemia of CKD. Methods: This phase 2a, exploratory, multicenter, single-arm study assessed the ability of daprodustat to increase or maintain hemoglobin concentrations within the target range (10...
July 2018: KI Reports
Fu-Jun Lin, Xi Zhang, Lu-Sheng Huang, Gang Ji, Hai-Dong Huang, Yun Xie, Geng-Ru Jiang, Xin Zhou, Wei Lu
PURPOSE: Although the association between anemia and cardiovascular mortality in hemodialysis patients is well established, whether hemoglobin variability (Hgb-Var) affects the prognosis remains unclear. We aimed to evaluate the association between Hgb-Var and cardiovascular mortality in Chinese hemodialysis patients. METHODS: This retrospective study included 252 patients starting hemodialysis in Xin Hua Hospital between January 2009 and December 2015. Patients were divided into three tertiles based on Hgb-Var, as reflected by SD Hgbmean , SD Hgbrange , and Hgbdeflection during a 12-month evaluation period after hemodialysis initiation...
July 4, 2018: International Urology and Nephrology
Ghada M El-Kannishy, Abir F Megahed, Mona M Tawfik, Ghada El-Said, Rabab T Zakaria, Nahed A Mohamed, Eman M Taha, Alzhraa A Ammar, Abeer M Abd Eltawab, Nagy A Sayed-Ahmed
Background: In dialysis patients, the obesity-survival paradox still requires an explanation. Anemia and high doses of erythropoiesis-stimulating agents (ESAs) are associated with worse outcomes in the hemodialysis (HD) population. In the present study, we explored the relation between obesity and anemia control in a sample of maintenance HD patients in Egypt. Methods: This multicenter observational study included 733 patients on maintenance HD from 9 hemodialysis centers in Egypt...
June 2018: Kidney Research and Clinical Practice
Guy Rostoker
Parenteral iron is used to restore the body's iron pool before and during erythropoiesis-stimulating agent (ESA) therapy; together these agents form the backbone of anemia management in end-stage renal disease (ESRD) patients undergoing hemodialysis. ESRD patients receiving chronic intravenous iron products, which exceed their blood loss are exposed to an increased risk of positive iron balance. Measurement of the liver iron concentration (LIC) reflects total body iron stores in patients with secondary hemosiderosis and genetic hemochromatosis...
June 28, 2018: Seminars in Dialysis
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