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Iron hemodialysis

Motoko Tanaka, Kazuki Yoshida, Shingo Fukuma, Kazuko Ito, Kazutaka Matsushita, Masafumi Fukagawa, Shunichi Fukuhara, Tadao Akizawa
OBJECTIVES: Anemia is an important prognostic factor in hemodialysis patients. It has been reported that parathyroidectomy ameliorates anemia and reduces the requirement of postoperative erythropoiesis-stimulating agents. The objective of this study was to assess the effect of cinacalcet, which is considered as a pharmacological parathyroidectomy, on anemia in hemodialysis patients. METHODS: We used data from a prospective cohort of Japanese hemodialysis patients with secondary hyperparathyroidism; the criteria were: intact parathyroid hormone concentrations ≥ 180 pg/mL or use of an intravenous or oral vitamin D receptor activator...
2016: PloS One
Reza Hekmat, Faeze Maghsudloo, Mahmood Mohebi, Sayed Abdolrahim Rezaee, Rosita Vakili, Hoshang Rafat Panah
Sexual dysfunction (SD) is a common problem in patients with the end-stage renal disease. In contrast to SD in males, relatively little work has been performed in the field of SD in females. In this study, we tried to identify the main determinants of SD in women aged 15-45year-old on chronic hemodialysis (HD). One hundred-forty female patients aged 15-45-year-old on chronic HD were studied in the winter of the year 2013. Healthy relatives of the patients were chosen as controls and matched for age, level of education, marital status, and income...
September 2016: Saudi Journal of Kidney Diseases and Transplantation
Tyler Albright, Akram Al-Makki, Rabih Kalakeche, Brian Shepler
PURPOSE: The objective of this short review is to evaluate the efficacy of ferric pyrophosphate citrate and to determine its place in therapy based on the current published literature. METHODS: A literature search was conducted and pared down to yield 4 placebo controlled Phase II and III clinically relevant trials. FINDINGS: Ferric pyrophosphate citrate is a new intradialytic iron supplementation product that has been found to reduce the dose of erythropoiesis-stimulating agents and intravenous iron supplementation and to increase serum ferritin concentrations...
September 27, 2016: Clinical Therapeutics
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
Janice Crespo-Salgado, V Matti Vehaskari, Tyrus Stewart, Michael Ferris, Qiang Zhang, Guangdi Wang, Eugene E Blanchard, Christopher M Taylor, Mahmoud Kallash, Larry A Greenbaum, Diego H Aviles
BACKGROUND: End-stage renal disease (ESRD) is associated with uremia and increased systemic inflammation. Alteration of the intestinal microbiota may facilitate translocation of endotoxins into the systemic circulation leading to inflammation. We hypothesized that children with ESRD have an altered intestinal microbiota and increased serum levels of bacterially derived uremic toxins. METHODS: Four groups of subjects were recruited: peritoneal dialysis (PD), hemodialysis (HD), post-kidney transplant and healthy controls...
2016: Microbiome
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
Wieneke M Michels, Bernard G Jaar, Patti L Ephraim, Yang Liu, Dana C Miskulin, Navdeep Tangri, Deidra C Crews, Julia J Scialla, Tariq Shafi, Stephen M Sozio, Karen Bandeen-Roche, Courtney J Cook, Klemens B Meyer, L Ebony Boulware
BACKGROUND: The effect of maintenance intravenous (IV) iron administration on subsequent achievement of anemia management goals and mortality among patients recently initiating hemodialysis is unclear. METHODS: We performed an observational cohort study, in adult incident dialysis patients starting on hemodialysis. We defined IV administration strategies over a 12-week period following a patient's initiation of hemodialysis; all those receiving IV iron at regular intervals were considered maintenance, and all others were considered non-maintenance...
September 6, 2016: Nephrology, Dialysis, Transplantation
Kazuomi Yamashita, Sonoo Mizuiri, Yoshiko Nishizawa, Shigemoto Kenichiro, Shigehiro Doi, Takao Masaki
BACKGROUND/AIM: Iron deficiency stimulates fibroblast growth factor 23 (FGF23) transcription. This study aimed to determine whether oral ferrous iron (Fe(2+) ) reduces the serum FGF23 levels of iron-deficient maintenance hemodialysis (MHD) patients in the same way as oral ferric iron (Fe(3+) ). METHODS: Thirty-one MHD patients with iron deficiency were enrolled in this prospective study. Patients who had taken iron supplements during the 8 weeks before the study were excluded...
August 25, 2016: Nephrology
Raymond D Pratt, Dorine W Swinkels, T Alp Ikizler, Ajay Gupta
Ferric pyrophosphate citrate (Triferic) is a water-soluble iron salt that is administered via dialysate to maintain iron balance and hemoglobin in hemodialysis patients. This double-blind, randomized, placebo-controlled, single-, ascending-dose study was conducted to evaluate the pharmacokinetics and safety of intravenous ferric pyrophosphate citrate in 48 healthy iron-replete subjects (drug, n = 36; placebo, n = 12). Single doses of 2.5, 5.0, 7.5, or 10 mg of ferric pyrophosphate citrate or placebo were administered over 4 hours, and single doses of 15 or 20 mg of ferric pyrophosphate citrate or placebo were administered over 12 hours via intravenous infusion...
August 25, 2016: Journal of Clinical Pharmacology
Jiacong Luo, Donna E Jensen, Bradley J Maroni, Steven M Brunelli
BACKGROUND: Hemodialysis patients with erythropoiesis-stimulating agent (ESA) hyporesponsiveness have been a topic of active research. However, there have been no studies of ESA hyporesponsiveness among US patients following the dramatic change in anemia management that resulted from the 2011 changes in ESA product labeling and bundling of dialysis remuneration. STUDY DESIGN: Retrospective observational study. SETTING & PARTICIPANTS: We studied prevalent hemodialysis patients treated at a large dialysis organization in calendar years 2012 to 2013 (N=98,972)...
August 12, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Adel Eftekhari, Khadijeh Nasiriani, Samaneh Mirzaei, Somayeh Azimpour Ardakani
INTRODUCTION: The restless leg syndrome (RLS) is a neurologic disorder suffering the hemodialysis patients. Although the pathophysiology of this syndrome remains unknown yet, an investigation of the parameters pertinent to it may help to develop the related medical knowledge and to improve the therapeutic-care interventions in this regard. OBJECTIVES: The correlation between the RLSs on individual, clinical, and laboratory indices in patients undergoing hemodialysis...
2016: Journal of Renal Injury Prevention
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
Scott Sibbel, Abigail Hunt, Suzanne Laplante, Werner Beck, Mary Gellens, Steven M Brunelli
Differences in dialyzer design may have consequences for patient outcomes. We evaluated the comparative effectiveness of commonly used dialyzers with respect to measures of dialysis treatment, anemia management, inflammation, and dialyzer clotting. Patients receiving hemodialysis between January 1, 2009, and December 31, 2013, and using polyarylethersulfone-polyvinylpyrrolidone (PAS-PVP; Polyflux Revaclear) or polysulfone (PS; Optiflux 160 or Optiflux 180) dialyzers were followed for 1 year or until end of study or censoring for dialyzer switch, modality change, or loss to follow-up...
September 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Akiyo Yamasaki, Koichiro Yoda, Hidenori Koyama, Shinsuke Yamada, Yoshihiro Tsujimoto, Senji Okuno, Shigeki Okada, Masaaki Inaba
BACKGROUND/AIMS: Fatigue is a common symptom in patients receiving hemodialysis (HD) and is generally associated with anemia. However, it can be difficult to resolve, even when anemia has been treated using erythropoiesis-stimulating agents and iron replacement therapy. In the present study, we examined the associations of anemia, the erythropoietin resistance index (ERI) and iron deficiency with fatigue during HD. METHODS: In this cross-sectional study, fatigue score was calculated on the basis of questionnaire responses in HD patients...
July 16, 2016: Nephron
Giacomo Bovio, Ciro Esposito, Giovanni Montagna, Silvia Brazzo, Vittoria Esposito, Massimo Torreggiani, Luca Semeraro, Hellas Cena
BACKGROUND/AIMS: It is very important to assess the nutritional intake in patients on dialysis given the high prevalence of poor nutritional status of those in this population. The aim of this study was to assess nutrient intakes in hemodialysis (HD) and peritoneal dialysis (PD) patients. METHODS: A clinical cross-sectional study was conducted over 7 days on 14 dialysis patients (98 days) who were trained to keep a weighed food record and a 7-day food diary. Nutrient intake adequacy was compared with specific guidelines for Italians and dialysis patients...
2016: Nephron
Fumihiko Koiwa, Akira Terao
BACKGROUND: Hyperphosphatemia is common in chronic kidney disease (CKD) and associated with mortality and morbidity. We aimed to evaluate the dose-dependent efficacy and safety of PA21 (sucroferric oxyhydroxide), an iron-based phosphate binder, in Japanese hemodialysis patients with hyperphosphatemia. METHODS: In this double-blind, multicenter, Phase II study, 183 patients were randomized to placebo or PA21 at doses of 250, 500, 750, or 1000 mg (based on iron content) three times/day for 6 weeks...
July 7, 2016: Clinical and Experimental Nephrology
Ji-Yeun Chang, Hanbeol Jang, Byung Ha Chung, Young-Ah Youn, In-Kyung Sung, Yong-Soo Kim, Chul Woo Yang
BACKGROUND: Successful pregnancy outcomes in patients with advanced chronic kidney disease (CKD) are increasingly common in Western countries. However, in Korea, the available literature addressing this clinical issue is scarce. METHODS: We reviewed 5 successful parturitions [1 patient with Stage 5 CKD and 4 with maintenance hemodialysis (HD)] at Seoul St. Mary's Hospital over 3 years and investigated changes in dialysis prescription, anemia management, and the incidence of maternal and neonatal complications...
June 2016: Kidney Research and Clinical Practice
J P Hu, X Cheng, X F Xu, G J Yu, F Luo, G S Zhang, N Yang, P Shen, X Y Yan
To explore the reactivity of patients with renal anemia (MHD) to erythropoietin (EPO) in maintenance hemodialysis (HD), 31 patients were enrolled in this study. According to the level of serum ferritin (SF), they were divided into two groups; one group received treatment using recombinant human erythropoietin (rHuEPO) and the other group was given iron sucrose. Taking terminal EPO dosage, terminal erythropoietin resistance index (ERI) and rate of change of ERI (ΔERII) as target indexes, the influence of SF level on dosage of EPO was evaluated after usage conditions of relevant substances in a 3-month period...
April 2016: Journal of Biological Regulators and Homeostatic Agents
Xin Cheng, Guojun Yu, Jiangping Hu, Xuefeng Xu, Fang Luo, Ping Shen, Guosheng Zhang, Ning Yang
The aim of the present study was to investigate the clinical effects of Shengxuening tablet (silkworm excrement) combined with recombinant human erythropoietin (rHuEPO) for the treatment of renal anemia of maintenance hemodialysis (MHD) patients. Seventy-two MHD patients with renal anemia were included in the study and randomly divided into the control (n=34) and observation (n=38) groups. Patients in the control group were treated by hypodermic injection of 100-150 U/(kg·w) rHuEPO and patients in the observation group were treated by rHuEPO + 1...
July 2016: Experimental and Therapeutic Medicine
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