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https://www.readbyqxmd.com/read/29153377/iatrogenic-iron-overload-and-its-potential-consequences-in-patients-on-hemodialysis
#1
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...
November 16, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/29142965/ferritin-elevation-and-improved-responsiveness-to-erythropoiesis-stimulating-agents-in%C3%A2-patients-on-ferric-citrate-hydrate
#2
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
https://www.readbyqxmd.com/read/29138677/oxidative-stress-in-hemodialysis-patients-a-review-of-the-literature
#3
REVIEW
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
https://www.readbyqxmd.com/read/29121874/evaluating-the-effectiveness-of-iv-iron-dosing-for-anemia-management-in-common-clinical-practice-results-from-the-dialysis-outcomes-and-practice-patterns-study-dopps
#4
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
https://www.readbyqxmd.com/read/29092738/optimizing-the-use-of-darbepoetin-%C3%AE-with-a-split-strategy-a-concept-change%C3%A2
#5
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
https://www.readbyqxmd.com/read/28948161/restless-legs-syndrome-is-contributing-to-fatigue-and-low-quality-of-life-levels-in-hemodialysis-patients
#6
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
https://www.readbyqxmd.com/read/28792166/evaluation-of-effect-of-ascorbic-acid-on-ferritin-and-erythropoietin-resistance-in-patients-of-chronic-kidney-disease
#7
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
https://www.readbyqxmd.com/read/28760431/predicting-clinical-outcomes-using-phase-angle-as-assessed-by-bioelectrical-impedance-analysis-in-maintenance-hemodialysis-patients
#8
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
https://www.readbyqxmd.com/read/28752141/neutrophil-gelatinase-associated-lipocalin-reflects-the-severity-of-anemia-without-iron-deficiency-and-secondary-hyperparathyroidism-in-hemodialysis-patients
#9
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
https://www.readbyqxmd.com/read/28748874/variables-affecting-darbepoetin-resistance-index-in-hemodialysis-patients
#10
Fayez Hejaili, Ehtsham Hafeez, Burhan Bhutto, Lulwa Al Turki, Abdul Kareem Alsuwida, Hammad Raza, Abdulla Al-Sayyari
Erythropoietin resistance index calculation has been used as a tool to evaluate anemia response to erythropoietin therapy. Very little has been reported in its use when using darbepoetin and factors influencing in Arab patients. Darbepoetin resistance index (DRI) was calculated in all our patients using darbepoetin. This was correlated to demographic, clinical, and laboratory parameters. Of the 250 patients, 40.4% were diabetic, 71.1% on hemodialysis, and 28.6% on hemodiafiltration), 23.9% with PermCaths (PC), and 76...
July 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28747155/indole-3-acetic-acid-indoxyl-sulfate-and-paracresyl-sulfate-do-not-influence-anemia-parameters-in-hemodialysis-patients
#11
Stanislas Bataille, Marion Pelletier, Marion Sallée, Yvon Berland, Nathalie McKay, Ariane Duval, Stéphanie Gentile, Yosra Mouelhi, Philippe Brunet, Stéphane Burtey
BACKGROUND: The main reason for anemia in renal failure patients is the insufficient erythropoietin production by the kidneys. Beside erythropoietin deficiency, in vitro studies have incriminated uremic toxins in the pathophysiology of anemia but clinical data are sparse. In order to assess if indole 3-acetic acid (IAA), indoxyl sulfate (IS), and paracresyl sulfate (PCS) -three protein bound uremic toxins- are clinically implicated in end-stage renal disease anemia we studied the correlation between IAA, IS and PCS plasmatic concentrations with hemoglobin and Erythropoietin Stimulating Agents (ESA) use in hemodialysis patients...
July 26, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28717516/costs-associated-with-intravenous-darbepoetin-versus-epoetin-therapy-in-hemodialysis-patients-a-randomized-controlled-trial
#12
Andrea L Woodland, Sean W Murphy, Bryan M Curtis, Brendan J Barrett
BACKGROUND: Anemia of chronic kidney disease is associated with adverse outcomes and a reduced quality of life. Erythropoiesis-stimulating agents (ESAs) have improved anemia management, and 2 agents are available in Canada, epoetin alfa (EPO) and darbepoetin alfa (DA). EPO and DA are considered equally effective in achieving target hemoglobin (Hb), but it is not clear whether there is a cost difference. There have been few head-to-head comparisons; most published studies are observational switch studies...
2017: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/28704813/serum-ferritin-variations-and-mortality-in-incident-hemodialysis-patients
#13
Taehee Kim, Elani Streja, Melissa Soohoo, Connie M Rhee, Rieko Eriguchi, Tae Woo Kim, Tae Ik Chang, Yoshitsugu Obi, Csaba P Kovesdy, Kamyar Kalantar-Zadeh
BACKGROUND: Higher serum ferritin levels may be influenced by iron use and inflammation, and are associated with higher mortality in hemodialysis (HD) patients. We hypothesized that a major rise in serum ferritin is associated with a higher risk of mortality, irrespective of baseline serum ferritin in incident HD patients. METHODS: In a cohort of 93,979 incident HD patients between 2007 and 2011, we examined the association of change in serum ferritin from the baseline patient quarter (first 91 days from dialysis start) to the subsequent quarter with mortality...
2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/28699885/does-helicobacter-pylori-infection-play-a-role-in-iron-deficiency-anemia-in-hemodialysis-patients
#14
Hisham El-Said, Aber Halim Baki Attallah, Zainab A Ali-Eldin
BACKGROUND: Among the disorders that may affect patients with end-stage renal disease (ESRD), anemia is the most responsive to treatment; any reversible cause should be identified, and the most common reversible cause is iron deficiency. We investigated the relationship between <italic>Helicobacter pylori</italic> infection and iron deficiency anemia in a hemodialysis population. MATERIALS AND METHODS: This cross-sectional study included 90 adult patients with ESRD on maintenance hemodialysis...
October 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28674560/-management-of-chronic-hemodialysis-patients-with-anemia-case-study-conducted-in-the-department-of-nephrology-and-hemodialysis-at-the-university-hospital-point-g-in-mali
#15
Alhadji Ahmadou Tounkara, Abdoul Mahama Sériba Coulibaly, Nouhoun Coulibaly, Békaye Traoré, Mahamane Kalil Maïga
INTRODUCTION: Anemia is a frequent complication of Chronic Kidney Disease CKD commonly found in chronic haemodialysis patients. Patients management is mainly based on erythropoietin administration and iron supplementation. This study aimed to evaluate the management of chronic hemodialysis patients with anemia in the Department of Nephrology and Hemodialysis at the University Hospital Point G in Mali. METHODS: We conducted a cross-sectional study from 1 to 31 August 2016...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28662118/low-levels-of-serum-ferritin-and-moderate-transferrin-saturation-lead-to-adequate-hemoglobin-levels-in-hemodialysis-patients-retrospective-observational-study
#16
Chie Ogawa, Ken Tsuchiya, Naohisa Tomosugi, Fumiyoshi Kanda, Kunimi Maeda, Teiryo Maeda
BACKGROUND: Optimal iron levels in patients on hemodialysis are currently unknown, and a higher level than that for the healthy population is usually set for such patients considering the use of erythropoiesis-stimulating agents or the occurrence of chronic inflammation. However, excessive iron causes oxidative stress and impairment of its utilization by cells. Therefore we investigated the relationship between hemoglobin (Hb) level and iron status in hemodialysis patients to identify the optimal iron levels for patients undergoing hemodialysis...
2017: PloS One
https://www.readbyqxmd.com/read/28652444/reticulocyte-hemoglobin-content-helps-avoid-iron-overload-in-hemodialysis-patients-a-retrospective-observational-study
#17
Domenico Capone, Mauro Cataldi, Mauro Vinciguerra, Teresa Mosca, Salvatore Barretta, Annalisa Ragosta, Aniello Sorrentino, Alessandra Vecchione, Luca Barretta, Giovanni Tarantino
BACKGROUND/AIM: Anemia in patients suffering from end-stage renal failure is currently treated with Erythropoiesis-Stimulating Agents (ESA). This treatment needs sufficient iron supplementation to avoid an inadequate dosage of ESA. Nowadays modern analytical instruments allow to accurately calculate the content of Hemoglobin (Hb) in reticulocytes (CHr), that can be used as a guide for prescribing patients with the appropriate amount of iron. PATIENTS AND METHODS: Patients, undergoing hemodialysis, were retrospectively selected from the database and were divided in two groups: group A received intravenous (IV) iron and subcutaneously ESA, and their dosages were adjusted on the basis of the following parameters: Hb, Mean corpuscular haemoglobin (MCH), CHr with consequent MCH/CHr ratio and reticulocyte count determined by the ADVIA 120 Hematology System of Siemens; group B patients were administered IV iron and ESA monitoring iron storage, Hb and ferritin...
July 2017: In Vivo
https://www.readbyqxmd.com/read/28648314/direct-cost-for-treating-chronic-kidney-disease-at-an-outpatient-setting-of-a-tertiary-hospital-evidence-from-a-cross-sectional-study
#18
Rajiv Ahlawat, Pramil Tiwari, Sanjay D'Cruz
BACKGROUND: Chronic kidney disease (CKD) has a high morbidity and mortality in developing countries. And this burden is also increasing rapidly in India. Unaffordability due to high cost of medication and hemodialysis remains one of the major barriers in the successful treatment of CKD. OBJECTIVES: To determine the direct cost involved in treating CKD at an outpatient department of a public tertiary care hospital. METHODS: This cross-sectional study was carried out at a public tertiary care hospital...
May 2017: Value in Health Regional Issues
https://www.readbyqxmd.com/read/28621798/the-relationship-of-serum-adipokines-with-malnutrition-inflammation-score-in-haemodialysis
#19
Elham Alipoor, Ahmad Esmaillzadeh, Mitra Mahdavi-Mazdeh, Mehdi Yaseri, Narges Sadat Zahed, Mohammad Javad Hosseinzadeh-Attar
BACKGROUND: Protein-energy wasting is a prevalent disorder in haemodialysis. Zinc-α2-glycoprotein (ZAG) and adipose triglyceride lipase (ATGL) are novel adipokines with recognized lipolytic effects and proposed role in metabolic homoeostasis. This study was conducted to investigate the association of ZAG and ATGL concentrations with malnutrition-inflammation score (MIS) and metabolic profile of patients with haemodialysis. MATERIALS AND METHODS: Eighty-eight patients under regular haemodialysis were divided based on MIS to normal to mild wasting (NMW; n = 35) or moderate wasting (MW; n = 53) group...
June 16, 2017: European Journal of Clinical Investigation
https://www.readbyqxmd.com/read/28587714/real-world-effectiveness-of-sucroferric-oxyhydroxide-in-patients-on-chronic-hemodialysis-a-retrospective-analysis-of-pharmacy-data%C3%A2
#20
Daniel W Coyne, Linda H Ficociello, Vidhya Parameswaran, Ludmila Anderson, Sharanya Vemula, Norma J Ofsthun, Claudy Mullon, Franklin W Maddux, Robert J Kossmann, Stuart M Sprague
AIMS: Hyperphosphatemia has been associated with an increased risk of mortality in patients with end-stage renal disease. We sought to assess the real-world effectiveness of sucroferric oxyhydroxide (SO), an iron-based phosphate binder (PB), in control of serum phosphorus levels, and to determine the associated pill burden in hemodialysis patients. MATERIALS AND METHODS: Adult, in-center hemodialysis patients first prescribed SO through a renal pharmacy service as part of routine clinical care between April 1, 2014 and March 31, 2015 were included in the analysis...
August 2017: Clinical Nephrology
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