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Iron hemodialysis

Andreza De Paula Santos Epifânio, Karla Pereira Balbino, Monica De Paula Jorge, Sonia M R Ribeiro, Ana Vládia Bandeira Moreira, Jerusa Maria Oliveira, Leandro Licursi Oliveira, Helen Hermana Miranda Hermsdorff
INTRODUCTION: Oxidative stress markers such as nitric oxide (NO) have been investigated in hemodialysis (HD). OBJECTIVE: Evaluate the association of NO variation with adiposity indicators, metabolic, inflammatory and oxidative stress markers in individuals to HD. METHODS: Cross-sectional study with 85 subjects on HD treatment (≥ 18 years). The clinical-nutritional status was evaluated through subjective global assessment modified (SGAm), anthropometric measurements and body composition...
January 10, 2018: Nutrición Hospitalaria: Organo Oficial de la Sociedad Española de Nutrición Parenteral y Enteral
Yoshitaka Isaka, Hideki Fujii, Yoshihiro Tsujimoto, Satoshi Teramukai, Takayuki Hamano
BACKGROUND: In dialysis patients, mortality risk due to cardiovascular diseases is remarkably high and prognosis is poor; coronary artery calcification is considered one of the major contributing factors. It is known that hyperphosphatemia is associated with coronary artery calcification. Therefore, controlling serum phosphate level and thereby mitigating vascular calcification could improve the poor prognosis of dialysis patients. However, the optimal phosphate level in dialysis patients remains unknown; hence, this study was planned to compare the effects of two types of non-calcium-based phosphate binders, and examine the effect of strict control of phosphate on coronary artery calcification...
March 13, 2018: Clinical and Experimental Nephrology
Ala Ali, Riyadh M Salih
Anemia is common in patients on hemodialysis (HD). Adequate iron stores are essential for achieving the best hemoglobin level through maximum benefit from erythropoiesis-stimulating agents (ESA). Decreased iron stores or decreased availability of iron are the most common reasons for resistance to the effect of these agents. Our objective was to categorize a group of Iraqi HD patients according to absolute or functional iron deficiency anemia (IDA); this study was conducted in the HD unit of the Baghdad Teaching Hospital from October 2012 to January 2013...
January 2018: Saudi Journal of Kidney Diseases and Transplantation
Jay B Wish, George R Aronoff, Bruce R Bacon, Carlo Brugnara, Kai-Uwe Eckardt, Tomas Ganz, Iain C Macdougall, Julio Núñez, Adam J Perahia, John C Wood
BACKGROUND: Regulation of body iron occurs at cellular, tissue, and systemic levels. In healthy individuals, iron absorption and losses are minimal, creating a virtually closed system. In the setting of chronic kidney disease and hemodialysis (HD), increased iron losses, reduced iron absorption, and limited iron availability lead to iron deficiency. Intravenous (IV) iron therapy is frequently prescribed to replace lost iron, but determining an individual's iron balance and stores can be challenging and imprecise, contributing to uncertainty about the long-term safety of IV iron therapy...
2018: American Journal of Nephrology
Chakradhari Inampudi, Paulino Alvarez, Rabea Asleh, Alexandros Briasoulis
Several risk factors including Ischemic heart disease, uncontrolled hypertension, high output heart failure (HF) from shunting through vascular hemodialysis access, and anemia, contribute to development of HF in patients with end-stage renal disease (ESRD). Guideline-directed medical and device therapy for Heart Failure with Reduced Ejection Fraction (HFrEF) has not been extensively studied and may have limited safety and efficacy in patients with ESRD. Maintenance of interdialytic and intradialytic euvolemia is a key component of HF management in these patients but often difficult to achieve...
January 23, 2018: Current Cardiology Reviews
Susana Pastor, Elisabeth Coll, Lara Rodríguez-Ribera, Elitsa Stoyanova, Zuray F Corredor, Ricard Marcos
End-stage renal disease (ESRD) patients present high levels of phosphorus and calcium products in serum, which contribute to the development of vascular calcification and cardiovascular disease, and to low iron stores and carnitine deficiency. For these reasons, ESRD patients are generally supplemented with different medicines. Some of the most common treatments include the use of Carnicor, Venofer, and Sevelamer drugs. Carnicor is used as a source of L-carnitine, acting as antioxidant and neuroprotector. Venofer is used to reduce the deficit of iron...
January 23, 2018: Environmental and Molecular Mutagenesis
Özlem Yayar, Barış Eser, Harun Kılıç
OBJECTIVE: In hemodialysis (HD) patients, cardiovascular disease (CVD) is the major cause of mortality and morbidity. In atherosclerotic diseases, iron gets accumulated in the arterial wall. Hepcidin is an important hormone in iron metabolism. Furthermore, hepcidin is associated with atherosclerotic disease. Therefore, this study aims to investigate the relation of serum hepcidin-25 (SH-25) and sub-clinic atherosclerosis measured by carotid intima-media thickness (CIMT) and mortality in HD patients...
January 17, 2018: Anatolian Journal of Cardiology
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
Shoab Saadat, Ayesha Aziz, Hira Ahmad, Hira Imtiaz, Zara S Sohail, Alvina Kazmi, Sanaa Aslam, Naveen Naqvi, Sidra Saadat
Objective To predict changes in the quality of life scores of hemodialysis patients for the coming month and the development of an early warning system using machine learning Methods It was a prospective cohort study (one-month duration) at the dialysis center of a tertiary care hospital in Pakistan. The study started on 1st October 2016. About 78 patients have been enrolled till now. Bachelor of Medicine and Bachelor of Surgery (MBBS) qualified doctors administered a proforma with demographics and the validated Urdu version of World Health Organization Quality Of Life-BREF (WHOQOL-BREF)...
September 25, 2017: Curēus
Gérard London, Johannes Mann, David Goldsmith, Christian Combe, Frank Dellanna, Philippe Zaoui, Nadja Hoebel, Andriy Krendyukov, Karen MacDonald, Ivo Abraham
AIMS: To assess real-world effectiveness and safety of intravenous (IV) HX575, a biosimilar epoetin-α, in hemodialysis (HD) patients. MATERIALS AND METHODS: This prospective, observational, pharmacoepidemiological study of adult HD patients treated with IV HX575 for renal anemia for up to 24 months was conducted in 114 centers in 10 European countries. Of 2,086 enrolled subjects (safety sample), 2,023 had ≥ 1 follow-up visit (effectiveness sample). RESULTS: Most (59...
January 2018: Clinical Nephrology
Guy Rostoker, Nosratola D Vaziri
Iron overload was considered rare in hemodialysis patients until recently, but its clinical frequency is now increasingly recognized. The liver is the main site of iron storage and the liver iron concentration (LIC) is closely correlated with total iron stores in patients with secondary hemosiderosis and genetic hemochromatosis. Magnetic resonance imaging (MRI) is now the gold standard method for estimating and monitoring LIC. Studies of LIC in hemodialysis patients by magnetic susceptometry thirteen years ago and recently by quantitative MRI have demonstrated a relation between the risk of iron overload and the use of intravenous (IV) iron products prescribed at doses determined by the iron biomarker cutoffs contained in current anemia management guidelines...
December 2017: La Presse Médicale
Keitaro Yokoyama, Masafumi Fukagawa, Takashi Akiba, Masaaki Nakayama, Toshiya Otoguro, Kana Yamada, Yasuo Nagamine, Steven Fishbane, Hideki Hirakata
Introduction: In hemodialysis patients on ferric citrate hydrate, the increase in ferritin level is mainly due to the administration of the compound. We investigated possible other factors associated with ferritin level and how erythropoietin resistance index and erythropoiesis in those patients were affected. We looked at ferritin-elevating factors using data from a Japanese phase III long-term clinical trial of ferric citrate hydrate. Methods: The factors with a strong association with ferritin levels at week 28 were selected by the process of variable selection...
May 2017: KI Reports
Vassilios Liakopoulos, Stefanos Roumeliotis, Xenia Gorny, Evangelia Dounousi, Peter R Mertens
Hemodialysis (HD) patients are at high risk for all-cause mortality and cardiovascular events. In addition to traditional risk factors, excessive oxidative stress (OS) and chronic inflammation emerge as novel and major contributors to accelerated atherosclerosis and elevated mortality. OS is defined as the imbalance between antioxidant defense mechanisms and oxidant products, the latter overwhelming the former. OS appears in early stages of chronic kidney disease (CKD), advances along with worsening of renal failure, and is further exacerbated by the HD process per se...
2017: Oxidative Medicine and Cellular Longevity
Bruce M Robinson, Maria Larkina, Brian Bieber, Werner Kleophas, Yun Li, Francesco Locatelli, Keith P McCullough, Jackie G Nolen, Friedrich K Port, Ronald L Pisoni
BACKGROUND: Anemia management protocols in hemodialysis (HD) units differ conspicuously regarding optimal intravenous (IV) iron dosing; consequently, patients receive markedly different cumulative exposures to IV iron and erythropoiesis-stimulating agents (ESAs). Complementary to IV iron safety studies, our goal was to gain insight into optimal IV iron dosing by estimating the effects of IV iron doses on Hgb, TSAT, ferritin, and ESA dose in common clinical practice. METHODS: 9,471 HD patients (11 countries, 2009-2011) in the DOPPS, a prospective cohort study, were analyzed...
November 9, 2017: BMC Nephrology
Marco Mendes, Ana Carina Ferreira, David Navarro, Bruno Pinto, Fernanda Gomes, Patrícia Matias, Cristina Jorge, Inês Aires, Aníbal Ferreira
As erythropoiesis is a continuous process, we hypothesized that a new approach with smaller doses of darbepoetin-α administered more regularly could result in fewer variations of its serum levels and be more effective. In a prevalent hemodialysis population, we evaluated the effects of the darbepoetin splitting in "mini-doses". A 34-month prospective study was performed in a cohort of 110 patients, with a mean age of 66.6 ± 14.2 years, median dialysis vintage of 63.6 months (IQ range: 27 - 86), 46.4% (n = 51) male gender, 36...
October 26, 2017: Clinical Nephrology
Christoforos D Giannaki, Michael Hadjigavriel, Akis Lazarou, Aristos Michael, Loukas Damianou, Efthimios Atmatzidis, Ioannis Stefanidis, Georgios M Hadjigeorgiou, Giorgos K Sakkas, Marios Pantzaris
AIM: To examine whether hemodialysis (HD) patients with restless legs syndrome (RLS) are subjects of greater fatigue and impaired quality of life (QoL) compared to HD patients without RLS. METHODS: Eighty five stable HD patients participated in this study. According to their RLS status, the patients were divided into the RLS group ( n = 23) and the non-RLS group ( n = 62). QoL, fatigue, sleep quality, daily sleepiness and depression symptoms were assessed by using various questionnaires...
September 6, 2017: World Journal of Nephrology
N Nand, A R Deshmukh, R Mittal
OBJECTIVE: This study was planned to evaluate the effect of short term intravenous ascorbic acid on reducing ferritin and erythropoietin resistance in patients of chronic kidney disease (CKD) on maintenance haemodialysis (MHD). METHODS: Forty adult patients [20 patients in group A with increased serum ferritin level (>500 ng/ml), transferrin saturation (TSAT) ≤20% and 20 patients in group B with normal serum ferritin level (<200 ng/ml), TSAT ≤20%] of end stage renal disease (ESRD) with erythropoietin hyporesponsiveness undergoing maintenance hemodialysis were included in the study...
July 2017: Journal of the Association of Physicians of India
Jung-Ho Shin, Chae Rim Kim, Ki Hyun Park, Jin Ho Hwang, Su Hyun Kim
OBJECTIVE: Protein-energy wasting is common in patients on hemodialysis and is an independent risk factor for adverse events. The aim of this study was to retrospectively investigate whether phase angle (PA), known as a nutritional marker, can predict various clinical outcomes in patients with end-stage renal disease (ESRD) who are receiving hemodialysis. METHODS: Using bioelectrical impedance analysis (BIA), PA was obtained every 6 mo, and patients were divided into two groups according to baseline PA: group A included patients with PA ≥4...
September 2017: Nutrition
Irem Pembegul Yigit, Ramazan Ulu, Nevzat Gozel, Hulya Taskapan, Necip Ilhan, Ayhan Dogukan
OBJECTIVE: Secondary hyperparathyroidism (SHPT) and anemia are the primary and most common complications in patients receiving hemodialysis (HD). Neutrophil gelatinase-associated lipocalin (NGAL) is a new marker to assess iron deficiency and manage iron therapy for HD patients. The aim of this study was to determine any association between serum NGAL level and anemia without iron deficiency in patients with SHPT on chronic HD. METHODS: Total of 61 SHPT patients on chronic HD were enrolled in the study and divided into 3 groups: mild SHPT group (n=17), moderate SHPT group (n=21), and severe SHPT group (n=23)...
2017: Northern Clinics of Istanbul
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