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Iron hemodialysis

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https://www.readbyqxmd.com/read/28446125/soluble-transferrin-receptor-as-a-marker-of-erythropoiesis-in-patients-undergoing-high-flux-hemodialysis
#1
Pei Yin, Jijun Li, Yan Song
Anemia is a common complication in chronic kidney disease (CKD) patients receiving hemodialysis. The effect of high-flux dialysis (HFD) on anemia remains unclear. This prospective study aimed to evaluate the effect of HFD on anemia, and the potential of soluble transferrin receptor (sTfR) as a marker of iron status and erythropoiesis in CKD patients on hemodialysis. Forty patients, who switched from conventional low-flux dialysis to HFD for 12 months, were enrolled in this study. The levels of sTfR, hemoglobin, iron, and nutritional markers, as well as the dose of recombinant human erythropoietin (rhEPO) and use of chalybeate were determined at 0, 2, 6, and 12 months after starting HFD...
April 27, 2017: Bosnian Journal of Basic Medical Sciences
https://www.readbyqxmd.com/read/28418614/efficacy-and-safety-of-low-dose-heparin-in-hemodialysis
#2
Mariana Murea, Gregory B Russell, Pirouz Daeihagh, Anita M Saran, Karan Pandya, Mark Cabrera, John M Burkart, Barry I Freedman
INTRODUCTION: The dose of unfractionated heparin (UFH) administered during hemodialysis (HD) varies widely. This prospective study evaluated the safety and efficacy of UFH dose de-escalation. METHODS: Sixty-six prevalent patients on HD receiving UFH per standard-dose protocol (load dose [LD] 50-75 units/kg, maintenance dose [MD] 500-1000 units/hour) had heparin prescription converted to low-dose protocol (start LD 15 units/kg and MD 500 units/hour; dose adjusted in small increments based on assessments of extracorporeal blood circuit)...
April 18, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28416170/hepcidin-serum-levels-and-resistance-to-recombinant-human-erythropoietin-therapy-in-hemodialysis-patients
#3
Kristina Petrulienė, Edita Žiginskienė, Vytautas Kuzminskis, Irena Nedzelskienė, Inga Arūnė Bumblytė
OBJECTIVE: The aim of this study was to analyze the factors that are associated with the response to erythropoiesis-stimulating agents (ESAs) and its association with hospitalization and mortality rates; to evaluate the serum hepcidin level and its associations with iron profile, inflammatory markers, ESA responsiveness, and mortality; and to determine independent factors affecting ERI and hepcidin. MATERIALS AND METHODS: To evaluate a dose-response effect of ESAs we used the erythropoietin resistance index (ERI)...
March 31, 2017: Medicina
https://www.readbyqxmd.com/read/28381747/the-resection-of-thyroid-cancer-was-associated-with-the-resolution-of-hyporesponsiveness-to-an-erythropoiesis-stimulating-agent-in-a-hemodialysis-patient-with-aceruloplasminemia
#4
Soichiro Nagata, Naoki Ikegaya, Shuhei Ogino, Shinichi Uchida, Mikiko Itaya, Aoi Momita, Shingo Shinozaki, Masaharu Ohura, Ken Kuriki, Satoshi Kono, Hiroaki Miyajima, Akira Hishida
We herein report the case of a hemodialysis patient whose response to an erythropoiesis-stimulating agent (ESA) improved following the resection of thyroid cancer. Her hemoglobin level remained below 7 g/dL, despite the use of ESA. During the search for the causes of her hyporesponsiveness to ESA, papillary thyroid cancer and aceruloplasminemia were found. The existence of other potential causes, such as iron deficiency, infectious disease, severe hyperparathyroidism and malnutrition were ruled out. Following the resection of the thyroid cancer tumor, her hemoglobin level increased to 10...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28372549/the-ferumoxytol-for-anemia-of-ckd-trial-fact-a-randomized-controlled-trial-of-repeated-doses-of-ferumoxytol-or-iron-sucrose-in-patients-on-hemodialysis-background-and-rationale
#5
Iain C Macdougall, Naomi V Dahl, Kristine Bernard, Zhu Li, Alka Batyky, William E Strauss
BACKGROUND: Iron deficiency anemia (IDA) is a common manifestation of chronic kidney disease (CKD), affecting most patients on hemodialysis and imposing a substantial clinical burden. Treatment with iron supplementation increases hemoglobin levels and can reduce the severity of anemia in patients with CKD. While correcting anemia in these patients is an important therapeutic goal, there is a lack of long-term trials directly comparing intravenous iron therapies in patients with CKD receiving hemodialysis...
April 3, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28371203/the-available-intravenous-iron-formulations-history-efficacy-and-toxicology
#6
REVIEW
Michael Auerbach, Iain Macdougall
A number of intravenous iron formulations have been developed over the past 65 years which rely on dextran or other compounds to prevent uncontrolled release of free iron to the circulation. High molecular weight dextran was associated with a number of serious adverse reactions and was removed from markets worldwide in 2009. The preponderance of published evidence suggests that the formulations of parenteral iron currently available in the United States, including low molecular weight iron dextran, are all safe and effective and there are no major, clinically important differences among them in terms of either efficacy or safety...
June 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28371161/ferric-pyrophosphate-citrate-as-an-iron-replacement-agent-for-patients-receiving-hemodialysis
#7
REVIEW
Steven Fishbane, Hitesh H Shah
Treatment of anemia remains an integral component in the care of patients with end stage kidney disease receiving dialysis. Currently, both erythropoiesis stimulating agents and iron replacement agents remain important anemia management strategies for patients undergoing hemodialysis (HD). Ferric pyrophosphate citrate (FPC) was approved by the U.S. Food and Drug Administration in January 2015 as an iron replacement product in adult patients receiving long-term maintenance HD. FPC is administered to patients on HD through the dialysate...
June 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28370957/safety-of-intravenous-iron-in-hemodialysis-patients
#8
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/28353202/a-single-dialysis-session-of-hemodiafiltration-with-sorbent-regenerated-endogenous-ultrafiltrate-reinfusion-hfr-removes-hepcidin-more-efficiently-than-bicarbonate-hemodialysis-a-new-approach-to-containing-hepcidin-burden-in-dialysis-patients
#9
Nicola Tessitore, Albino Poli, Valeria Bedogna, Luca Corazza, Natascia Campostrini, Mauro Atti, Luisa Sereni, Annalisa Castagna, Domenico Girelli, Giuseppina Pessolano, Antonio Lupo
BACKGROUND: Most hemodialysis patients have high Hepcidin-25 levels, which may be involved in the pathogenesis of several uremic complications related to an altered iron biology. The hemodialysis procedure itself can influence Hepcidin-25 levels by removing Hepcidin-25 and maybe stimulating its production due to a pro-inflammatory effect. METHODS: To assess the relationship between dialysis-related inflammation and intradialysis changes in Hepcidin-25, we performed a crossover trial in 28 hemodialysis patients to compare the effects on serum levels of Hepcidin-25 and inflammatory markers activated during dialysis [Tumor Necrosis Factor-α (TNF-α), Interleukin-6, C-reactive protein (CRP), Pentraxin-3] of a single dialysis session using a technique capable of reducing inflammation, HFR (Hemo Filtrate Reinfusion: a hemodiafiltration system combining convection, diffusion and adsorption) or bicarbonate-dialysis using either the same low-flux membrane as in the diffusion stage of HFR (LFBD) or a high-flux membrane (HFBD)...
March 28, 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/28341375/risk-factors-for-mortality-in-patients-undergoing-hemodialysis-a-systematic-review-and-meta-analysis
#10
Lijie Ma, Sumei Zhao
BACKGROUND: No consensus exists regarding the factors influencing mortality in patients undergoing hemodialysis (HD). This meta-analysis aimed to evaluate the impact of various patient characteristics on the risk of mortality in such patients. METHODS: PubMed, Embase, and Cochrane Central were searched for studies evaluating the risk factors for mortality in patients undergoing HD. The factors included age, gender, diabetes mellitus (DM), body mass index (BMI), previous cardiovascular disease (CVD), HD duration, hemoglobin, albumin, white blood cell, C-reactive protein (CRP), parathyroid hormone, total iron binding capacity (TIBC), iron, ln ferritin, adiponectin, apolipoprotein A1 (ApoA1), ApoA2, ApoA3, high-density lipoprotein (HDL), total cholesterol, hemoglobin A1c (HbA1c), serum phosphate, troponin T (TnT), and B-type natriuretic peptide (BNP)...
February 22, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28332306/impact-of-iatrogenic-iron-overload-on-the-course-of-hepatitis-c-in-the-dialysis-population-a-plea-for-caution
#11
REVIEW
Guy Rostoker, Nosratola D Vaziri
About 2.5% of the world population, corresponding to about 177 million individuals, are infected by hepatitis C virus (HCV), a small, single-stranded RNA virus. The prevalence of HCV infection among dialysis patients in Japan, Europe, and North America during the 2012 to 2015 period was found to be 8.7% in the DOPPS study. Nosocomial HCV spread in hemodialysis facilities still occurs. Increased hepatic tissue iron has been shown to play a deleterious role in the course of hepatitis C, favor development of fibrosis and cirrhosis and possibly increase the risk of liver cancer in the general population...
June 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28328144/diagnosing-and-preventing-iron-overload
#12
REVIEW
Ganesh Ramanathan, John K Olynyk, Paolo Ferrari
Absolute or functional iron (Fe) deficiency is an important determinant of anemia in hemodialysis patients and parenteral Fe is routinely used to treat this condition in conjunction with erythropoiesis stimulating agents. While restoration of hemoglobin toward the target range is a good outcome of Fe replacement, it is well known that Fe overload and toxicity may be adverse consequences of this therapy. Dialysis clinical practice guidelines recommend tailoring Fe therapy based on transferrin saturation and serum ferritin levels...
June 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28320343/targets-for-adapting-intravenous-iron-dose-in-hemodialysis-a-proof-of-concept-study
#13
N O Peters, N Jay, J Cridlig, G Rostoker, L Frimat
BACKGROUND: Intravenous iron is widely used to control anemia in dialysis patients and limits costs related to erythropoiesis-stimulating agents (ESA). Current guidelines do not clearly set upper limits for serum ferritin (SF) and transferrin saturation (TSAT). International surveys such as the Dialysis Outcomes and Practice Patterns Study (DOPPS) showed that this lack of upper limits potentially led nephrologists to prescribe iron infusions even for patients with a high SF. Recent publications have suggested a risk of short- and long-term adverse effects related to iron overload...
March 20, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28294512/hfe-mutations-and-iron-in-hemodialysis-patients
#14
REVIEW
Luca Valenti, Serena Pelusi
In chronic hemodialysis patients, a disruption in iron metabolism ranging from absolute to functional deficiency, with compartmentalization of this metal into macrophages, is often observed. Chronic inflammation indeed often causes an upregulation of the iron hormone hepcidin, thereby reducing iron absorption and availability to the erythron. We systematically reviewed the literature on the role of genetic risk factors on iron metabolism in hemodialysis. In this setting, mutations in the HFE gene of hereditary hemochromatosis may confer an adaptive benefit by decreasing hepcidin release, thus improving iron availability to erythropoiesis, anemia control, and the response to erythropoiesis stimulating agents and iron itself, and reducing the side effects of these therapies...
June 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28291504/hepcidin-clearance-is-associated-with-erythropoietin-requirement-in-stable-hemodialysis-patients%C3%A2
#15
Damien Ashby, Mark Busbridge, Sarah Hildebrand, Candice Clarke, Georgina Aldous, Mitul Palan, Kevin Murphy, Neill Duncan, Peter Choi
BACKGROUND: The discovery of hepcidin, the hormone regulating iron absorption and transport, has improved the understanding of anemia and erythropoietin treatment. Excessive hepcidin signaling causes anemia in chronic inflammatory conditions by restricting iron delivery to the bone marrow. Hepcidin is normally eliminated in the urine, and the high levels seen in renal failure are thought to contribute to renal anemia and resistance to erythropoietin. METHODS: Clearance of hepcidin by hemodialysis was investigated in this study by measurement of plasma hepcidin before and after a single dialysis session in 204 patients...
May 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28285317/efficacy-of-intravenous-iron-sucrose-in-hemodialysis-patients-with-restless-legs-syndrome-rls-a-randomized-placebo-controlled-study
#16
Yinghui Deng, Jinglin Wu, Qiang Jia
BACKGROUND Restless legs syndrome (RLS) is a common disorder in hemodialysis (HD) patients that causes sleep disturbances and diminished quality of life. Because iron deficiency has been implicated in the pathogenesis of RLS, we sought to investigate the effects of intravenous (IV) iron sucrose on symptoms of RLS in HD patients. MATERIAL AND METHODS The study was a randomized, placebo-controlled study of 1000 mg iron sucrose versus normal saline as placebo. Patients were evaluated at baseline and 2 weeks after the last injection...
March 12, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28242135/hypoxia-inducible-factor-prolyl-hydroxylase-inhibitors-a%C3%A2-potential-new-treatment-for-anemia-in-patients-with-ckd
#17
REVIEW
Nupur Gupta, Jay B Wish
Erythropoiesis-stimulating agents (ESAs) increase hemoglobin levels, reduce transfusion requirements, and have been the standard of treatment for anemia in patients with chronic kidney disease (CKD) since 1989. Many safety concerns have emerged regarding the use of ESAs, including an increased occurrence of cardiovascular events and vascular access thrombosis. Hypoxia-inducible factor (HIF) prolyl hydroxylase (PH) enzyme inhibitors are a new class of agents for the treatment of anemia in CKD. These agents work by stabilizing the HIF complex and stimulating endogenous erythropoietin production even in patients with end-stage kidney disease...
February 24, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28182039/hemodialysis-outcomes-and-practice-patterns-in-end-stage-renal-disease-experience-from-a-tertiary-care-hospital-in-kerala
#18
G R Lakshminarayana, L G Sheetal, A Mathew, R Rajesh, G Kurian, V N Unni
This study was planned to analyze the hemodialysis practice patterns from a tertiary care referral centre as there is very limited data from India. All patients of ESRD on maintenance hemodialysis (MHD) in dialysis unit at AIMS, Kochi, Kerala for a minimum period of 3 months were included. A total of 134 patients (M: F 2:1) with age of 20 to 84 years (Mean: 59.83; SD: 11.98) were studied. The most common causes of ESRD in study population were diabetic nephropathy (DN) (59.7%) followed by unclassified group (19...
January 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/28173916/effect-of-mineral-and-bone-metabolism-on-restless-legs-syndrome-in-hemodialysis-patients
#19
Precil D M M Neves, Fabiana G Graciolli, Ivone B Oliveira, Ramaiane A Bridi, Rosa M A Moysés, Rosilene M Elias
STUDY OBJECTIVES: Restless legs syndrome (RLS) is a highly prevalent sleep disease among patients on hemodialysis. The physiopathology is still unclear, and may be multifactorial. Because of the association between iron metabolism and chronic kidney disease-mineral and bone disorders (CKD-MBD), we hypothesized that both factors would be associated with RLS. METHODS: We have evaluated hemodialysis patients, in a face-to-face interview for the diagnosis and severity of RLS, as measured by the International Restless Legs Syndrome Study Group...
January 15, 2017: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/28163506/related-factors-and-predictors-of-cognitive-dysfunction-in-chronic-kidney-disease-on-maintenance-hemodialysis-in-nigeria
#20
Lukman Femi Owolabi, Aliyu Abdu, Aliyu Ibrahim, Desola Shakirah Owolabi, Aisha Nalado, Adamu Bappa, Aminu Abdullahi Taura
BACKGROUND: Previous studies suggest a high frequency of cognitive impairment (CI) in persons with chronic kidney disease (CKD); however, factors associated with CI and predictors of CI in persons with CKD remain largely unclear. The aim of this study was to determine the factors associated with CI and predictors of CI in CKD patients on maintenance hemodialysis. MATERIALS AND METHODS: The first stage of the study included recruitment of 100 apparently healthy participants aimed at determining the reference values...
December 2016: Journal of Neurosciences in Rural Practice
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