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Anemia hemodialysis

Tomonari Harada, Masaru Obokata, Koji Kurosawa, Hidemi Sorimachi, Kuniko Yoshida, Hideki Ishida, Kyoko Ito, Tetsuya Ogawa, Yoshitaka Ando, Masahiko Kurabayashi, Kazuaki Negishi
Hemodialysis patients have conditions that increase cardiac output (CO), including arteriovenous fistula, fluid retention, vasodilator use, and anemia. We sought to determine the relationships between these factors and CO and to evaluate the effects of the high-output states on ventricular morphology, function, and myocardial energetics in hemodialysis patients, using noninvasive load-insensitive indices. Cardiovascular function was assessed in hemodialysis patients with high output [ejection fraction ≥ 50%, cardiac index (CI) > 3...
October 16, 2018: International Journal of Cardiovascular Imaging
Hiroyuki Amagai, Kentaro Murakami, Haruhito Sakata, Masaya Uesato, Koichi Hayano, Masayuki Kano, Takeshi Fujishiro, Takeshi Toyozumi, Senba Yoshihide, Kohei Yamamoto, Hideki Hayashi, Hisahiro Matsubara
Introduction Cancer patients undergoing hemodialysis might be under-treated because the pharmacokinetics of anti-cancer drugs in such patients remain unknown and out of concern related to the potential development of severe adverse effects. However, patients with chemosensitive cancer, such as esophageal cancer, should receive chemotherapy at a dose that is sufficient to attain a favorable therapeutic effect. We herein present an interesting case involving an esophageal cancer patient who was successfully treated with subtotal thoracic esophagectomy, and adjuvant full-dose chemotherapy with cisplatin and 5-fluorouracil while concomitantly undergoing hemodialysis...
October 10, 2018: Journal of Oncology Pharmacy Practice
Francesc Maduell, Lara Belmar, Jésica Ugalde, Montserrat Laguno, María Martínez-Rebollar, Raquel Ojeda, Marta Arias, Lida Rodas, Florencia Rossi, Laura-Patricia Llovet, Leonardo Nicolás González, Josep Mallolas, Maria-Carlota Londoño
INTRODUCTION: In the interferon era, the treatment of hepatitis C virus (HCV) infection in patients on haemodialysis (HD) was limited due to the significant number of treatment-related adverse events (AEs). Direct-acting antivirals (DAAs) have demonstrated their efficacy and safety in the treatment of HCV in patients with advanced chronic kidney disease on haemodialysis. The objective of the study was to evaluate the success in eliminating HCV infection from our dialysis unit using DAAs, and to assess the impact of HCV elimination on clinical and analytical outcomes...
October 4, 2018: Gastroenterología y Hepatología
Vassilios Liakopoulos, Stefanos Roumeliotis, Sotirios Zarogiannis, Theodoros Eleftheriadis, Peter R Mertens
Oxidative stress (OS) is the result of prooxidant molecules overwhelming the antioxidant defense mechanisms. Hemodialysis (HD) constitutes a state of elevated inflammation and OS, due to loss of antioxidants during dialysis and activation of white blood cells triggering production of reactive oxygen species. Dialysis vintage, dialysis methods, and type and condition of vascular access, biocompatibility of dialyzer membrane and dialysate, iron administration, and anemia all can play a role in aggravating OS, which in turn has been associated with increased morbidity and mortality...
October 4, 2018: Seminars in Dialysis
Wei Xiong, Fang-Fang He, Ren-Yu You, Jing Xiong, Yu-Mei Wang, Chun Zhang, Xian-Fang Meng, Hua Su
Chronic kidney disease (CKD) is an increasing major public health problem worldwide. The number of CKD patients on hemodialysis is growing rapidly as well. Acupuncture technique is one of the traditional Chinese medicine methods and has been used in a variety of diseases. Nowadays, the clinical application of acupuncture technique for CKD patients has become the focus for its effectiveness and security. In this paper, we will review the therapeutic effects and mechanisms of different acupuncture techniques for CKD patients...
2018: American Journal of Chinese Medicine
James B Wetmore, Suying Li, Heng Yan, Hairong Xu, Yi Peng, Marvin V Sinsakul, Jiannong Liu, David T Gilbertson
Whether and how anemia treatment with erythropoiesis stimulating agents (ESAs) before hemodialysis initiation may be associated with lower mortality after dialysis initiation is unknown. We compared all-cause and cardiovascular mortality in two groups of patients who experienced distinct anemia treatment patterns with ESAs before and after hemodialysis initiation. This retrospective cohort analysis included patients initiating hemodialysis April 1, 2012-June 30, 2013, identified from United States Renal Data System end-stage renal disease (ESRD) and pre-ESRD files...
2018: PloS One
Jalal Azmandian, Mohammad Reza Abbasi, Vahid Pourfarziani, Amir Ahmad Nasiri, Shahrzad Ossareh, Shahrokh Ezzatzadegan Jahromi, Hooshang Sanadgol, Somayeh Amini, Arshia Shahvaroughi Farahani
BACKGROUND: Anemia is one of the most prevalent complications in patients with chronic kidney disease, which is believed to be caused by the insufficient synthesis of erythropoietin by the kidney. This phase III study aimed to compare the efficacy and safety of CinnaPoietin® (epoetin beta, CinnaGen) with Eprex® (epoetin alfa, Janssen Cilag) in the treatment of anemia in ESRD hemodialysis patients. METHODS: In this randomized, active-controlled, double-blind, parallel, and non-inferiority trial, patients were randomized to receive either CinnaPoietin® or Eprex® for a 26-week period...
September 25, 2018: American Journal of Nephrology
Masaki Hara, Yuya Nakamura, Hiroki Suzuki, Rin Asao, Masayuki Nakamura, Kazumasa Nishida, Sachiyo Kenmotsu, Masahiro Inagaki, Mayumi Tsuji, Yuji Kiuchi, Isao Ohsawa, Yoshikazu Goto, Hiromichi Gotoh
BACKGROUND/AIMS: Hepcidin-25 (HEP-25) and erythroferrone (ERFE) are key regulators of iron homeostasis. Correlations among serum ferritin, ERFE, and HEP-25 levels and improvements in anemia have not been evaluated after administration of ferric citrate hydrate (FCH). METHODS: This retrospective observational study investigated 24 patients on hemodialysis with both anemia (hemoglobin [Hb] < 12 g/dL) and hyperphosphatemia (inorganic phosphorus ≥ 6 mg/dL). The patients who were administered FCH (1,500 mg/day) for 12 consecutive weeks and 12 control patients who were administered a phosphate binder other than FCH were included...
September 21, 2018: Nephrology
Jesse M G Hofman, Michele F Eisenga, Adry Diepenbroek, Ilja M Nolte, Bastiaan van Dam, Ralf Westerhuis, Stephan J L Bakker, Casper F M Franssen, Carlo A J M Gaillard
BACKGROUND: Although the efficacy of iron sucrose (IS) and ferric carboxymaltose (FCM) in treating anemia in hemodialysis (HD) patients has been studied individually, a comparison of these two intravenous iron formulations has not yet been performed in HD patients. METHODS: We performed a retrospective audit on records of 221 stable HD patients from different HD centers in the Netherlands, who were switched from IS to FCM on a 1:1 ratio. To assess the effect of the switch on iron status parameters, data from 3 time points before and 3 time points after the switch were analyzed using linear mixed effects models...
September 20, 2018: BMC Nephrology
Meire Nikaido Suzuki, Brisa Maria Fregonesi, Carolina Sampaio Machado, Guilherme Sgobbi Zagui, Luciana Kusumota, Adriano Kamimura Suzuki, José Abrão Cardeal da Costa, Jordi Sierra Llopart, Martí Nadal, Jose Luis Domingo, Susana Segura-Muñoz
Contamination by metals and microbiological agents in hemodialysis water can cause clinical intercurrences in hemodialysis patients. Evaluating and assuring minimum levels of contamination from metals and microorganisms in hemodialysis water can improve patient safety. The objective of this study was to assess hemodialysis water quality in a major tertiary hospital in Brazil and investigate the relationship between hemodialysis water quality and clinical intercurrences in hemodialysis patients. A prospective-observational cohort study for evaluation of water quality parameters and clinical intercurrences present by patients (n = 52) were performed from May 2014 to April 2015...
September 14, 2018: Biological Trace Element Research
Ravi Thadhani, Ruffy Guilatco, Jeffrey Hymes, Franklin W Maddux, Ajay Ahuja
BACKGROUND: For patients with anemia undergoing hemodialysis, erythropoiesis-stimulating agents (ESAs) are typically dosed via precise algorithms. Using one such algorithm, we assessed the maintenance of hemoglobin levels in patients switched from epoetin alfa reference product (Epogen®) to epoetin alfa-epbx (RetacritTM; a biosimilar to US-licensed Epogen®/Procrit®). METHODS: This randomized, open-label, non-inferiority study was conducted at Fresenius Medical Care North America (FMCNA) hemodialysis centers...
2018: American Journal of Nephrology
Aya Shinfuku, Toshiharu Shimazaki, Masanori Fujiwara, Fumihiko Sato, Hirotaka Watase, Takumi Numazaki, Yasunori Kawakita, Masaru Mutoh, Hironori Yamasaki, Noriko Takayama, Sota Kato, Tomohiro Sugimoto, Jinsei Maruyama
BACKGROUND: TP0463518 is a novel hypoxia-inducible factor prolyl hydroxylase inhibitor developed to aid in the treatment of anemia associated with chronic kidney disease (CKD) and is expected to increase erythropoietin (EPO) derived from liver. Two phase I studies were conducted in healthy volunteers (HV) and CKD patients undergoing hemodialysis (i.e., HD patients) or those not undergoing dialysis (i.e., ND patients). METHODS: Pharmacokinetics, pharmacodynamics, and safety profiles of TP0463518 were assessed...
2018: American Journal of Nephrology
Maxime Touzot, Thibaud Lefebvre, Arthur Roux, Catherine Maheas, Christophe Ridel, Hervé Puy, Zoubida Karim
AIM: Relatively few hemodialysis patients (HD) remain independent of recombinant human EPO ("rHU-EPO free patients"). We investigated the role of EPO and Hepcidin, two key hormones involved in anemia. METHODS: we report a monocentric Case-control serie. Iron status, EPO and Hepcidin levels were analysed in 15 Adult HD (Age>18 years) with a stable hemoglobin level that have not received rHU-EPO for at least 6 months (=rHU-EPO free patients); and in 60 controls with a stable rHU-EPO dose and hemoglobin level...
September 3, 2018: Nephrology
Mohamed A Mekky, Mohamed O Abdel-Malek, Heba A Osman, Essam M Abdel-Aziz, Abdel-Kader A Hashim, Helal F Hetta, Khairy H Morsy
BACKGROUND: Till now, pooled data about the safety and efficacy of different direct-acting antiviral (DAAs) regimens in different renal situations are still under evaluation. AIM: To evaluate a real-life experience of the efficacy and safety of ombitasvir/paritaprevir/ritonavir plus ribavirin (OBV/PTV/r plus RIB) in patients with end-stage kidney disease (ESKD). PATIENTS AND METHODS: Between January 2017 and January 2018, an open-label multicenter prospective study was designed to enroll all consecutive patients with proven CHC genotype 4 infections and concomitant ESKD based on estimated glomerular filtration rate (eGFR) with (HD group) or without hemodialysis (non-HD group)...
August 27, 2018: Clinics and Research in Hepatology and Gastroenterology
Gabriela Lacreta, Sérgio Gardano Elias Bucharles, Gabriela Sevignani, Miguel Carlos Riella, Marcelo Mazza do Nascimento
INTRODUCTION: Anemia is a frequent multifactorial complication of CKD seen in patients on dialysis derived mainly from impaired erythropoietin (EPO) production. A less common cause of anemia in individuals with CKD is pure red cell aplasia (PRCA) secondary to the production of anti-EPO antibodies. OBJECTIVE: This paper aimed two describe two cases of PRCA secondary to the production of anti-EPO antibodies including choice of treatment, patient progression, and a literature review...
August 23, 2018: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
Marie Patrice Halle, Tangie Larry, Cecile Okalla, Nda Mefo'o, Fouda Hermine, Gloria Ashuntantang
Hepatitis C virus (HCV) infection one of the most common blood-borne infections is endemic in Cameroon and a serious problem in hemodialysis (HD). We aimed to determine the annual incidence and factors associated with seroconversion to hepatitis C positivity amongst patients on maintenance HD after an exposition of two years in a center with a high prevalence of hepatitis C (20.6%) and where no isolation policy is practiced. This was a retrospective cohort study carried out in January 2015 in the HD unit of Douala General Hospital in Cameroon including 71 patients on maintenance HD who tested negative for HCV in January 2013...
July 2018: Saudi Journal of Kidney Diseases and Transplantation
Yumei Zhang, Chun Hu, Zhixiang Bian, Peihua Chen
There are a lot of controversies pertaining to correctness of timing for the initiation of dialysis in chronic kidney disease (CKD) patients. The present study was conducted to examine the potential association of initiation timing of dialyses with long-term prognosis in CKD patients. In total, 294 patients confirmed as end-stage renal disease (ESRD) were included as study subjects. According to the estimated glomerular filtration rate (eGFR) at initiation time, the patients were classified into four groups based on eGFR: ≥10...
August 2018: Experimental and Therapeutic Medicine
Yael Einbinder, Timna Agur, Kirill Davidov, Tali Zitman-Gal, Eliezer Golan, Sydney Benchetrit
BACKGROUND: Anemia management strategies among chronic hemodialysis patients with high ferritin levels remains challenging for nephrologists. OBJECTIVES: To compare anemia management in stable hemodialysis patients with high (≥ 500 ng/ml) vs. low (< 500 ng/ml) ferritin levels. METHODS: In a single center, record review, cohort study of stable hemodialysis patients who were followed for 24 months, an anemia management policy was amended to discontinue intravenous (IV) iron therapy for stable hemodialysis patients with hemoglobin > 10 g/dl and ferritin ≥ 500 ng/ml...
July 2018: Israel Medical Association Journal: IMAJ
Sevcan A Bakkaloğlu, Yaşar Kandur, Erkin Serdaroğlu, Aytül Noyan, Aysun Karabay Bayazıt, Mehmet Taşdemir, Sare Gülfem Özlü, Gül Özçelik, İsmail Dursun, Caner Alparslan, Meltem Akcaboy, Yeşim Özdemir Atikel, Gönül Parmaksız, Bahriye Atmış, Lale Sever
BACKGROUND: During erythropoietin-stimulating agent (ESA) treatment, hemoglobin (Hb) levels usually fluctuate; this phenomenon is known as "Hb cycling (HC)." In this study, we aimed to evaluate the predictors of HC and its impact on left ventricular hypertrophy (LVH) as a patient-important outcome parameter in pediatric dialysis patients. METHODS: Records of patients followed up in nine pediatric nephrology centers between 2008 and 2013 were reviewed. More than 1 g/dL decrease or increase in Hb level was considered as HC...
November 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
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
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