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Iron hemodialysis

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https://www.readbyqxmd.com/read/28328144/diagnosing-and-preventing-iron-overload
#1
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...
March 22, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28320343/targets-for-adapting-intravenous-iron-dose-in-hemodialysis-a-proof-of-concept-study
#2
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
#3
Luca Valenti, Serena Pelusi
INTRODUCTION: 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. METHODS: we systematically reviewed the literature on the role of genetic risk factors on iron metabolism in hemodialysis...
March 15, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28291504/hepcidin-clearance-is-associated-with-erythropoietin-requirement-in-stable-hemodialysis-patients%C3%A2
#4
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...
March 14, 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
#5
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
#6
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
#7
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
#8
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
#9
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
https://www.readbyqxmd.com/read/28153964/anemia-in-peritoneal-dialysis-patients-iron-repletion-current-and-future-therapies
#10
REVIEW
Ahmed Zeidan, Sunil Bhandari
Iron deficiency, both functional and absolute, is common in patients with chronic kidney disease (CKD), especially those requiring dialysis. Guidelines advocate treatment of iron-deficiency anemia in patients with CKD and those on peritoneal dialysis (PD). Oral iron is often insufficient and slow to improve hemoglobin concentrations because of high hepcidin levels causing impaired absorption and mobilization, while intravenous (IV) supplementation replenishes and maintains iron stores more effectively and is now standard practice (Kidney Disease Improving Global Outcomes [KDIGO] 2012 guidelines)...
January 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/28130911/the-relationship-of-serum-hemojuvelin-and-hepcidin-levels-with-iron-level-and-erythropoietin-requirement-in-prevalent-hepatitis-c-virus-positive-hemodialysis-patients
#11
Heba W El Said, Khaled H Abou Seif, Yasser S Ahmed, Hesham A Abou Elleil, Tamer W El Said, Maha A Behairy, Mohamed M Mohamed, Fatma A Ahmed
BACKGROUND: Iron overload is frequently reported in hemodialysis (HD) patients particularly those with chronic hepatitis C virus (HCV) infection. Soluble Hemojuvelin (sHJV) has recently emerged as one of the significant regulators of iron homeostasis and hepcidin expression. AIMS: to evaluate the potential associations of sHJV and hepcidin with inflammation, iron parameters and Erythropoietin requirement in prevalent HD patients with HCV. METHODS: Serum sHJV and hepcidin were measured in 60 prevalent HD patients with [group I (n = 30)] and without [group II (n = 30)] HCV, and controls (n = 30) by enzyme-linked immunosorbent assay...
January 28, 2017: Nephrology
https://www.readbyqxmd.com/read/28124030/signal-intensity-ratio-mri-accurately-estimates-hepatic-iron-load-in-hemodialysis-patients
#12
Guy Rostoker, Mireille Laroudie, Raphaël Blanc, Bernard Galet, Clémentine Rabaté, Mireille Griuncelli, Yves Cohen
BACKGROUND: Iron overload, diagnosed by means of magnetic resonance imaging (MRI), is an increasingly recognized disorder in hemodialysis patients. Specific MRI protocols have been shown to provide a reliable estimation of tissue iron content in non-renal patient populations but have not been validated in dialysis patients. Such validation studies require liver biopsy for histological comparison, but this invasive and risky procedure raises ethical concerns, especially regarding frail patients with end-stage renal disease...
January 2017: Heliyon
https://www.readbyqxmd.com/read/28111930/hfe-gene-mutation-is-a-risk-factor-for-tissue-iron-accumulation-in-hemodialysis-patients
#13
Ercan Turkmen, Tolga Yildirim, Rahmi Yilmaz, Tuncay Hazirolan, Gonca Eldem, Engin Yilmaz, Aysun Aybal Kutlugun, Mahmut Altindal, Bulent Altun
INTRODUCTION: HFE gene mutations are responsible from iron overload in general population. Studies in hemodialysis patients investigated the effect of presence of HFE gene mutations on serum ferritin and transferrin saturation (TSAT) with conflicting results. However effect of HFE mutations on iron overload in hemodialysis patients was not previously extensively studied. METHODS: 36 hemodialysis patients (age 51.3 ± 15.6, (18/18) male/female) and 44 healthy control subjects included in this cross sectional study...
January 23, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28063734/safety-of-intravenous-iron-in-hemodialysis-longer-term-comparisons-of-iron-sucrose-versus-sodium-ferric-gluconate-complex
#14
Wolfgang C Winkelmayer, Benjamin A Goldstein, Aya A Mitani, Victoria Y Ding, Medha Airy, Sreedhar Mandayam, Tara I Chang, M Alan Brookhart, Steven Fishbane
BACKGROUND: Controversy exists about any differences in longer-term safety across different intravenous iron formulations routinely used in hemodialysis (HD) patients. We exploited a natural experiment to compare outcomes of patients initiating HD therapy in facilities that predominantly (in ≥90% of their patients) used iron sucrose versus sodium ferric gluconate complex. STUDY DESIGN: Retrospective cohort study of incident HD patients. SETTING & PARTICIPANTS: Using the US Renal Data System, we hard-matched on geographic region and center characteristics HD facilities predominantly using ferric gluconate with similar ones using iron sucrose...
January 4, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28043577/mycobacterium-haemophilum-a-report-of-cutaneous-infection-in-a-patient-with-end-stage-renal-disease
#15
Shahram Sabeti, Mahsa Pourabdollah Tootkaboni, Mitra Abdolahi, Mihan Pourabdollah
INTRODUCTION: Mycobacterium haemophilum is a slow-growing nontuberculous mycobacterium (NTM) that can cause ulcerating cutaneous or subcutaneous nodular skin lesions in immunocompromised and immunocompetent patients. Acid-fast staining cannot distinguish NTM from M. tuberculosis; culturing at two temperatures with iron-supplemented media and polymerase chain reaction (PCR) are needed for optimal detection of M. haemophilum. CASE PRESENTATION: A 32-year-old man with end-stage renal disease, undergoing hemodialysis twice a week, presented with multiple, painless, nonpruritic nodular lesions...
December 2016: International Journal of Mycobacteriology
https://www.readbyqxmd.com/read/27991479/gulf-cooperation-council-dialysis-outcomes-and-practice-patterns-study-an-overview-of-anemia-management-trends-at-the-regional-and-country-specific-levels-in-the-gulf-cooperation-council-countries
#16
Samra Abouchacra, Ali Obaidli, Saeed M G Al-Ghamdi, Jamal Al Wakeel, Issa Al Salmi, Sumaya Al Ghareeb, Mohammad Al Azmi, Mohammed Elsayed, Brian A Bieber, Ronald L Pisoni
The Gulf Cooperation Council-Dialysis Outcomes and Practice Patterns Study (GCC-DOPPS) marks the joining of the six Gulf region countries including Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates to the main DOPPS study in 2012. The current review is a descriptive reporting on results related to the management of anemia from these countries. Our data demonstrate consistent anemia management patterns across the GCC countries allowing the achievement of international treatment levels...
November 2016: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/27971344/cost-outcome-analysis-of-different-intravenous-iron-sucrose-preparations-in-hemodialysis-patients
#17
M Bourdoncle, D Sémély, C Porteils, S Oses, A Pagès, Labadens, M Parmier, B Juillart-Condat, A Del Bello
No abstract text is available yet for this article.
November 2016: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/27957820/inter-method-variability-of-ferritin-and-transferrin-saturation-measurement-methods-in-patients-on-hemodialysis
#18
Daigo Kamei, Ken Tsuchiya, Hitomi Miura, Kosaku Nitta, Takashi Akiba
Serum ferritin level and transferrin saturation (TSAT) are widely used to evaluate iron status in patients with chronic kidney disease, and are also important variables for performing statistical analyses. Many guidelines have set control targets or upper limits for these markers. Inter-method variability is an important consideration in iron control and statistical analysis. We used 10 ferritin assay kits and five iron/unsaturated iron-binding capacity/total iron-binding capacity assay kits to determine ferritin levels and TSAT in 114 patients on maintenance dialysis, and evaluated measurement bias using Passing-Bablok regression analyses...
February 2017: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/27951582/oral-low-dose-ferric-citrate-is-a-useful-iron-source-for-hyperphosphatemic-hemodialysis-patients-a-case-series
#19
Masayuki Tanemoto, Yu Ishimoto, Hisako Saito
BACKGROUND: Randomized trials have demonstrated that a phosphate binder ferric citrate (FeC) increases iron parameters in comparison with other phosphate binders, but the doses for FeC to improve iron stores safely have not been clarified. METHODS: We examined changes of iron parameters and blood hemoglobin (Hb) in 7 iron-deficient hemodialysis (HD) patients taking FeC 750 mg/day as a phosphate binder. RESULTS: The median serum transferrin saturation and ferritin increased from 13% (interquartile range (IQR) 7-18) to 28% (IQR 22-31; p = 0...
2017: Blood Purification
https://www.readbyqxmd.com/read/27941640/fibroblast-growth-factor-23-a-potential-uremic-toxin
#20
REVIEW
Piotr Kuczera, Marcin Adamczak, Andrzej Wiecek
Fibroblast growth factor-23 (FGF23) is a circulating member of the FGF family produced mainly by the osteocytes and osteoblasts that can act as a hormone. The main action of FGF23 is to lower phosphatemia via the reduction of urinary phosphate reabsorption and the decrease of 1,25(OH)₂-D generation in the kidney. In the course of chronic kidney disease (CKD), plasma FGF23 concentration rises early, most probably to compensate the inability of the deteriorating kidneys to excrete an adequate amount of phosphate...
December 8, 2016: Toxins
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