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https://www.readbyqxmd.com/read/29296795/erythropoiesis-stimulating-agents-in-elderly-patients-with-anemia-response-and-cardiovascular-outcomes
#1
Zachary Gowanlock, Swetha Sriram, Alison Martin, Anargyros Xenocostas, Alejandro Lazo-Langner
A specific cause of anemia cannot be identified in many elderly patients. Erythropoiesis-stimulating agents (ESAs) may play a role in treating these patients with anemia of unknown etiology (AUE). This study examines hemoglobin and cardiovascular outcomes among elderly anemic patients treated with ESAs. We conducted a retrospective cohort study that included all anemic patients older than age 60 years who had erythropoietin (EPO) measured between 2005 and 2013 at a single center. Three independent reviewers used defined criteria to assign each patient's anemia to 1 of 4 groups: chronic kidney disease (CKD), myelodysplastic syndrome, AUE, or other etiology...
August 22, 2017: Blood Advances
https://www.readbyqxmd.com/read/29296077/hx575-established-biosimilarity-in-the-treatment-of-renal-anemia-and-10-years-of-clinical-experience
#2
REVIEW
Frank Dellanna, David Goldsmith, Andriy Krendyukov, Andreas Seidl, Nadja Höbel, Christian Combe
Erythropoiesis-stimulating agents, such as recombinant human erythropoietin, are commonly used for the treatment of anemia in patients with chronic kidney disease (CKD). In 2007, HX575 (Binocrit®) became the first biosimilar epoetin alfa to be approved by the European Medicines Agency (EMA). The decision to approve a biosimilar is based on the totality of evidence obtained in a comprehensive comparability exercise that involves extensive analytical characterization, nonclinical studies and clinical studies...
2018: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/29241199/change-in-hemoglobin-trajectory-and-darbepoetin-dose-approaching-end-stage-renal-disease-data-from-the-trial-to-reduce-cardiovascular-events-with-aranesp-therapy-trial
#3
Finnian R Mc Causland, Brian Claggett, Marc A Pfeffer, Emmanuel A Burdmann, Kai-Uwe Eckardt, Andrew S Levey, John J V McMurray, Giuseppe Remuzzi, Ajay K Singh, Scott D Solomon, Robert D Toto, Patrick Parfrey
BACKGROUND: The pathogenesis of chronic kidney disease associated anemia is multifactorial and includes decreased production of erythropoietin (EPO), iron deficiency, inflammation, and EPO resistance. To better understand the trajectory of these parameters, we described temporal trends in hemoglobin (Hb), ferritin, transferrin saturation, C-reactive protein (CRP), and darbepoetin dosing in the Trial to Reduce cardiovascular Events with Aranesp Therapy (TREAT). METHODS: We performed a post hoc analysis of 4,038 participants in TREAT...
December 14, 2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/29237106/home-therapy-to-reduce-office-visits-for-patients-with-chronic-kidney-disease-and-anemia
#4
Monica V Riley, Joy Vess, Bonnie Pleasants Dumas
Anemia is a common complication of chronic kidney disease (CKD) and a predictor of increased mortality. This project integrated erythropoietin-stimulating agent (ESA) with CKD care under one practice setting, co-managing anemia with CKD while reducing frequency of office visits in a rural setting. Patients self-administered their weekly dosage of erythropoietin with monthly follow-ups. As a result, office visits decreased by 56% for patients with CKD Stage 4 and by 54% for patients with CKD Stage 5.
January 2017: Nephrology Nursing Journal: Journal of the American Nephrology Nurses' Association
https://www.readbyqxmd.com/read/29228345/mechanisms-and-mediators-of-hypertension-induced-by-erythropoietin-and-related-molecules
#5
Rajiv Agarwal
Hypertension is a common but frequently overlooked adverse effect of erythropoietin (EPO) therapy. Underreporting of hypertension with EPO is likely due to either more aggressively managing hypertension through the prescription of antihypertensive drugs or closer attention to dry weight. The purpose and focus of this review is to critically evaluate the mechanisms of EPO-induced hypertension. Preclinical data are considered first, followed by clinical data where available. Mediated by a variety of molecules, there is an imbalance in the vascular tone favoring net vasoconstriction that mediates EPO-induced hypertension...
December 8, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29227261/clinical-features-of-therapy-of-anemia-and-the-significance-of-its-fluctuation-in-the-development-of-anemia-in-dialysis-patients
#6
E Lapina, M Batiushin, V Terentiev, M Gasanov, A Gasanova
The aim of our study was to examine the features of therapy of anemia, and the influence of fluctuation in dose of antianemic drugs on hemoglobin levels in dialysis patients. The study included 100 patients with chronic kidney disease stage 5D receiving hemodialysis, mean age was 53,4±15,8 years. The clinical and anamnestic data were studied and laboratory tests were performed in all patients. The correlation between hemoglobin level and fluctuations in dose of antianemic drugs for 12 months: erythropoietin (R= -0,51, p=0,004) and iron (R= -0,46, p=0,01) was determined...
November 2017: Georgian Medical News
https://www.readbyqxmd.com/read/29141943/anemia-at-older-age-etiologies-clinical-implications-and-management
#7
Reinhard Stauder, Peter Valent, Igor Theurl
Anemia is quite frequently diagnosed in older individuals and is a key indicator of various reactive and clonal conditions. Many underlying diseases, like the myelodysplastic syndromes (MDS), develop preferentially in elderly individuals. The prevalence of anemia at older age is increasing, and this is mainly due to more frequently applied diagnostics and demographic changes in our societies. The etiology of anemia at older age is complex and ranges from bone marrow failure syndromes to chronic kidney disease, and from nutritional deficiencies to inflammatory processes including inflammaging in immunosenescence...
November 15, 2017: Blood
https://www.readbyqxmd.com/read/29137321/the-role-of-indoxyl-sulfate-in-renal-anemia-in-patients-with-chronic-kidney-disease
#8
Chih-Jen Wu, Cheng-Yi Chen, Thung-S Lai, Pei-Chen Wu, Chih-Kuang Chuang, Fang-Ju Sun, Hsuan-Liang Liu, Han-Hsiang Chen, Hung-I Yeh, Chih-Sheng Lin, Cheng-Jui Lin
Renal anemia is a common complication in patients with advanced chronic kidney disease. In vitro studies have shown that indoxyl sulfate decreases erythropoietin production. Whether this effect is seen in vivo remains unclear. Our goal was to explore the role of indoxyl sulfate in renal anemia. We found serum indoxyl sulfate levels are significantly and negatively associated with erythropoietin levels in human. A multiple stepwise linear regression analyses after adjustment for other independent parameters revealed that free indoxyl sulfate, and total indoxyl sulfate were significantly associated with erythropoietin levels...
October 10, 2017: Oncotarget
https://www.readbyqxmd.com/read/29132915/human-recombinant-erythropoietin-reduces-sensorimotor-dysfunction-and-cognitive-impairment-in-rat-models-of-chronic-kidney-disease
#9
E E Reza-Zaldívar, S Sandoval-Avila, Y K Gutiérrez-Mercado, E Vázquez-Méndez, A A Canales-Aguirre, H Esquivel-Solís, U Gómez-Pinedo, A L Márquez-Aguirre
INTRODUCTION: Chronic kidney disease (CKD) can cause anaemia and neurological disorders. Recombinant human erythropoietin (rHuEPO) is used to manage anaemia in CKD. However, there is little evidence on the effects of rHuEPO on behaviour and cognitive function in CKD. This study aimed to evaluate the impact of rHuEPO in sensorimotor and cognitive functions in a CKD model. METHODS: Male Wistar rats were randomly assigned to 4 groups: control and CKD, with and without rHuEPO treatment (1050 IU per kg body weight, once weekly for 4 weeks)...
November 10, 2017: Neurología: Publicación Oficial de la Sociedad Española de Neurología
https://www.readbyqxmd.com/read/29123429/assessment-of-prescribed-medications-and-pattern-of-distribution-for-potential-drug-drug-interactions-among-chronic-kidney-disease-patients-attending-the-nephrology-clinic-of-lagos-university-teaching-hospital-in-sub-saharan-west-africa
#10
Olumuyiwa John Fasipe, Peter Ehizokhale Akhideno, Obiyo Nwaiwu, Alex Adedotun Adelosoye
Introduction: Life expectancy has increased significantly among chronic kidney disease (CKD) patients due to the extensive use of polypharmacy practice for medication prescriptions. This predisposes them to potential drug-drug interactions (DDIs), which can lead to an increase in morbidity, mortality, length of hospital stay, and health care cost. Methods: This was a 30-month retrospective study that reviewed the medical case records of consenting adult CKD patients from January 2014 to June 2016...
2017: Clinical Pharmacology: Advances and Applications
https://www.readbyqxmd.com/read/29103135/association-of-adiposity-with-hemoglobin-levels-in-patients-with-chronic-kidney-disease-not-on-dialysis
#11
Hirokazu Honda, Kota Ono, Tadao Akizawa, Kosaku Nitta, Akira Hishida
BACKGROUND: In the general population, adiposity influences erythropoiesis and iron metabolism. We aimed to assess the relationships between adiposity [estimated by body mass index (BMI) and abdominal circumference (AC)] and biomarkers of erythropoiesis in patients with chronic kidney disease (CKD) not on dialysis. METHODS: A total of 2322 patients from the Chronic Kidney Disease Japan Cohort study were included. Patients were grouped according to BMI (low: < 18...
November 4, 2017: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/29097481/efficacy-and-long-term-safety-of-c-e-r-a-maintenance-in-pediatric-hemodialysis-patients-with-anemia-of-ckd
#12
Michel Fischbach, Elke Wühl, Sylvie C Meyer Reigner, Zoe Morgan, Franz Schaefer
BACKGROUND AND OBJECTIVES: The study was conducted to identify a conversion factor for switching from previous erythropoiesis-stimulating agents (ESAs) to continuous erythropoietin receptor activator-methoxy polyethylene glycol-epoetin beta (C.E.R.A.) and to document the efficacy and long-term safety of C.E.R.A. in pediatric patients with anemia of CKD undergoing hemodialysis. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: In this open-label, multicenter study, patients aged 6-17 years, with stable chronic anemia of CKD, undergoing hemodialysis received C...
November 2, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29074377/dual-therapeutic-effects-of-an-albumin-based-nitric-oxide-donor-on-two-experimental-models-of-chronic-kidney-disease
#13
Shun Oshiro, Yu Ishima, Maeda Hitoshi, Naoko Honda, Bi Jing, Ryo Kinoshita, Mayumi Ikeda, Yasunori Iwao, Tadashi Imafuku, Kento Nishida, Sigeyuki Miyamura, Hiroshi Watanabe, Masaki Otagiri, Toru Maruyama
Chronic kidney disease (CKD) is accompanied by a variety of complications, typically renal anemia and kidney fibrosis. Accordingly, it is desirable to develop the novel therapeutics that can treat these CKD conditions. Since nitric oxide (NO) has multiple functions including hypoxia inducible factor (HIF) stabilizing, anti-inflammatory, anti-oxidative and anti-apoptoic activities, the use of NO for the CKD therapy has attracted considerable interest. Here, we evaluate the therapeutic impacts of S-nitrosated human serum albumin (SNO-HSA), a long-lasting NO donor, on two animal models of CKD...
October 23, 2017: Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/29073196/fgf23-expression-in-rodents-is-directly-induced-via-erythropoietin-after-inhibition-of-hypoxia-inducible-factor-proline-hydroxylase
#14
Ingo Flamme, Peter Ellinghaus, Diana Urrego, Thilo Krüger
Plasma levels of FGF23 are increased in patients with chronic kidney disease. Beside its role in phosphate homeostasis, iron deficiency and anemia are associated with increased FGF23 plasma levels. Recently, FGF23 plasma levels were shown to be increased in mice after treatment with hypoxia inducible factor-proline hydroxylase (HIF-PH) inhibitors which are strong inducers of erythropoietin and erythropoiesis and are known to modulate iron uptake and availability. Therefore we investigated a potential context between expression of FGF23 and stimulation of erythropoiesis using a HIF-PH inhibitor and erythropoietin in rats...
2017: PloS One
https://www.readbyqxmd.com/read/29044949/induction-of-erythropoietin-gene-expression-in-epithelial-cells-by-chemicals-identified-in-gata-inhibitor-screenings
#15
Hiroshi Kaneko, Takehide Katoh, Ikuo Hirano, Atsushi Hasegawa, Tadayuki Tsujita, Masayuki Yamamoto, Ritsuko Shimizu
Erythropoietin (EPO) is a hormone that promotes proliferation, differentiation and survival of erythroid progenitors. EPO gene expression is regulated in a tissue-specific and hypoxia-inducible manner and is mainly restricted to renal EPO-producing cells after birth. Chronic kidney disease (CKD) confers high risk for renal anemia due to lower EPO production from injured kidneys. In transgenic reporter lines of mice, disruption of a GATA-binding motif within the Epo gene promoter-proximal region restores constitutive reporter expression in epithelial cells...
October 18, 2017: Genes to Cells: Devoted to Molecular & Cellular Mechanisms
https://www.readbyqxmd.com/read/29033600/efficacy-and-safety-of-subcutaneous-administration-of-lyophilized-powder-of-alfa-erythropoietin-to-maintain-hemoglobin-concentrations-among-hemodialysis-patients
#16
Bancha Satirapoj, Rattanawan Dispan, Ouppatham Supasyndh
BACKGROUND: Anemia associated with chronic kidney disease (CKD) often requires treatment with recombinant human erythropoietin (EPO). This study investigated the therapeutic equivalence between lyophilized powder and standard liquid EPO alfa by subcutaneous (SC) administration in hemoglobin maintenance among patients on hemodialysis. METHODS: This was a single-blinded, randomized, controlled, single-center, parallel-group study regarding the treatment of anemia among CKD patients on hemodialysis and being treated with stable doses of EPO alfa at least for 12 weeks...
2017: International Journal of Nephrology and Renovascular Disease
https://www.readbyqxmd.com/read/29033594/cost-effectiveness-analysis-of-intravenous-ferumoxytol-for-the-treatment-of-iron-deficiency-anemia-in-adult-patients-with-non-dialysis-dependent-chronic-kidney-disease-in-the-usa
#17
Naomi V Dahl, Robert F Kaper, William E Strauss, Frank A Corvino, Marko Zivkovic
OBJECTIVE: Ferumoxytol has demonstrated superior efficacy compared with oral iron in treating iron deficiency anemia in chronic kidney disease (CKD) patients. However, an economic evaluation of ferumoxytol has not been conducted. The aim of this study was to analyze the cost-effectiveness of treating iron deficiency anemia in adult non-dialysis-dependent CKD patients with ferumoxytol as compared with oral iron, alone or in combination with erythropoietin-stimulating agents (ESAs). METHODS: A decision analytic model compared health outcomes and costs associated with 5-week outpatient treatment of adult non-dialysis-dependent CKD patients with ferumoxytol or oral iron, each as monotherapy or in combination with ESAs in the USA...
2017: ClinicoEconomics and Outcomes Research: CEOR
https://www.readbyqxmd.com/read/28989882/effect-of-short-term-erythropoietin-therapy-on-insulin-resistance-and-serum-levels-of-leptin-and-neuropeptide-y-in-hemodialysis-patients
#18
Hamed M Osman, Osama A Khamis, Mohamed S Elfeky, Amani M El Amin Ali, Mostafa Y Abdelwahed
INTRODUCTION: Insulin resistance (IR) is a known complication of end-stage kidney disease (ESKD). It may be an important therapeutic target in stages of chronic kidney disease. AIM: The study was conducted to evaluate the effect of short-term treatment with recombinant human erythropoietin (rHuEpo) therapy on IR, serum leptin, and neuropeptide Y in ESKD patients on hemodialysis. MATERIALS AND METHODS: Thirty ESKD patients were enrolled in the study and were randomly assigned into two groups...
September 2017: Indian Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28979782/elderly-patients-with-chronic-kidney-disease-do-they-really-need-referral-to-the-nephrology-clinic
#19
Mark McClure, Thomas Jorna, Laura Wilkinson, Joanne Taylor
INTRODUCTION: Chronic kidney disease (CKD) is becoming increasingly common, especially in the elderly. In the UK, there has been a marked increase in the awareness and detection of CKD over the last decade. This is largely attributable to the introduction of automated estimated glomerular filtration rate (eGFR) reporting and renal indicators in the primary care Quality and Outcomes Framework (QOF) initiative, both of which were introduced in 2006. These two initiatives have had a significant impact on referral patterns to renal services...
October 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28978825/pathogenesis-and-treatment-of-anemia-in-chronic-kidney-disease
#20
Masaomi Nangaku
Chronic kidney disease leads to dysfunction of renal erythropoietin-producing cells, resulting in a decrease in erythrocyte production. A decrease in oxygen delivery to vital organs due to anemia results in worse quality of life and is associated with poor prognosis of the patients. Treatment with human recombinant erythropoietin or its improved version of erythropoiesis-stimulating agent (ESA) with a longer half-life is effective. However, some patients show hyporesponsiveness to ESA. Hyporesponsiveness to ESA, which can be induced by factors such as inflammation and uremic toxins, is associated with poor prognosis...
2017: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
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