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Anemia and CKD

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https://www.readbyqxmd.com/read/29668766/prediction-of-hemoglobin-levels-in-individual-hemodialysis-patients-by-means-of-a-mathematical-model-of-erythropoiesis
#1
Doris H Fuertinger, Franz Kappel, Hanjie Zhang, Stephan Thijssen, Peter Kotanko
Anemia commonly occurs in people with chronic kidney disease (CKD) and is associated with poor clinical outcomes. The management of patients with anemia in CKD is challenging, due to its severity, frequent hypo-responsiveness to treatment with erythropoiesis stimulating agents (ESA) and common hemoglobin cycling. Nonlinear dose-response curves and long delays in the effect of treatment on red blood cell population size complicate predictions of hemoglobin (Hgb) levels in individual patients. A comprehensive physiology based mathematical model for erythropoiesis was adapted individually to 60 hemodialysis patients treated with ESAs by identifying physiologically meaningful key model parameters from temporal Hgb data...
2018: PloS One
https://www.readbyqxmd.com/read/29666917/measurement-of-iron-status-in-chronic-kidney-disease
#2
Wesley Hayes
Anemia is a common complication of chronic kidney disease (CKD) in children, and dysregulation of iron homeostasis plays a central role in its pathogenesis. Optimizing iron status is a prerequisite for effective treatment of anemia. Insufficient iron can lead to inappropriate escalation of the erythropoiesis-stimulating agent (ESA) dose, which is associated with adverse outcomes. Excess iron supplementation also has negative sequelae including free radical tissue damage and increased risk of systemic infection...
April 17, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/29659573/whole-body-iron-transport-and-metabolism-mechanistic-multi-scale-model-to-improve-treatment-of-anemia-in-chronic-kidney-disease
#3
Joydeep Sarkar, Alka A Potdar, Gerald M Saidel
Iron plays vital roles in the human body including enzymatic processes, oxygen-transport via hemoglobin and immune response. Iron metabolism is characterized by ~95% recycling and minor replenishment through diet. Anemia of chronic kidney disease (CKD) is characterized by a lack of synthesis of erythropoietin leading to reduced red blood cell (RBC) formation and aberrant iron recycling. Treatment of CKD anemia aims to normalize RBC count and serum hemoglobin. Clinically, the various fluxes of iron transport and accumulation are not measured so that changes during disease (e...
April 16, 2018: PLoS Computational Biology
https://www.readbyqxmd.com/read/29655605/physiology-and-pathophysiology-of-renal-erythropoietin-producing-cells
#4
REVIEW
Hong-Mou Shih, Chih-Jen Wu, Shuei-Liong Lin
Anemia is a common complication and contributes to increased morbidity and mortality in chronic kidney disease (CKD) patients. Whereas there has been a significant improvement of understanding the underlying mechanism of erythropoiesis, the treatment of renal anemia is still restricted to erythropoietin (EPO)-stimulating agents. The purpose of this article is to review the physiology of erythropoiesis, functional role of EPO and underlying molecular and cellular basis that regulate EPO production. Regulation of EPO production is at mRNA level...
April 11, 2018: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/29604324/effect-of-blood-t1-estimation-strategy-on-arterial-spin-labeled-cerebral-blood-flow-quantification-in-children-and-young-adults-with-kidney-disease
#5
Hua-Shan Liu, Abbas F Jawad, Nina Laney, Erum A Hartung, Susan L Furth, John A Detre
PURPOSE: To compare blood T1 estimation approaches used for quantifying cerebral blood flow (CBF) with arterial spin labeled (ASL) perfusion MRI in a developmental cohort of chronic kidney disease (CKD) patients with anemia and a control group. METHODS: 61 patients with CKD and 47 age-matched control subjects were studied. Blood T1 approaches included: (1) a fixed value, (2) estimation based on measured hematocrit (Hct), and (3) estimation based on Age+Sex using a published formula...
March 28, 2018: Journal of Neuroradiology. Journal de Neuroradiologie
https://www.readbyqxmd.com/read/29593859/a-threshold-trajectory-was-revealed-by-isolating-the-effects-of-hemoglobin-rate-of-rise-in-anemia-of-chronic-kidney-disease
#6
Gregory Fusco, Ali Hariri, Carlos Vallarino, Ajay Singh, Peter Yu, Lesley Wise
Background: To assess cardiovascular risk among various hemoglobin (Hb) rates of rise (RoR) in chronic kidney disease (CKD) patients with anemia who have initiated therapy with erythropoiesis stimulating agents (ESAs). Methods: Observational cohort of CKD patients initiating ESA therapy from the Centricity® database, 1990-2011. Proportional hazards models tested the hypothesis that a slower Hb RoR (0 < g/dl/month ⩽ 0.125) is associated with a lower cardiovascular (CV) incidence [composite of fatal/nonfatal myocardial infarction (MI) and stroke] compared with faster RoR (0...
October 2017: Therapeutic Advances in Drug Safety
https://www.readbyqxmd.com/read/29590102/common-%C3%AE-globin-variants-modify-hematologic-and-other-clinical-phenotypes-in-sickle-cell-trait-and-disease
#7
Laura M Raffield, Jacob C Ulirsch, Rakhi P Naik, Samuel Lessard, Robert E Handsaker, Deepti Jain, Hyun M Kang, Nathan Pankratz, Paul L Auer, Erik L Bao, Joshua D Smith, Leslie A Lange, Ethan M Lange, Yun Li, Timothy A Thornton, Bessie A Young, Goncalo R Abecasis, Cathy C Laurie, Deborah A Nickerson, Steven A McCarroll, Adolfo Correa, James G Wilson, Guillaume Lettre, Vijay G Sankaran, Alex P Reiner
Co-inheritance of α-thalassemia has a significant protective effect on the severity of complications of sickle cell disease (SCD), including stroke. However, little information exists on the association and interactions for the common African ancestral α-thalassemia mutation (-α3.7 deletion) and β-globin traits (HbS trait [SCT] and HbC trait) on important clinical phenotypes such as red blood cell parameters, anemia, and chronic kidney disease (CKD). In a community-based cohort of 2,916 African Americans from the Jackson Heart Study, we confirmed the expected associations between SCT, HbC trait, and the -α3...
March 28, 2018: PLoS Genetics
https://www.readbyqxmd.com/read/29581249/hypoxia-inducible-factor-prolyl-hydroxylase-inhibitor-roxadustat-fg-4592-protects-against-cisplatin-induced-acute-kidney-injury
#8
Yunwen Yang, Xiaowen Yu, Yue Zhang, Guixia Ding, Chunhua Zhu, Songming Huang, Zhanjun Jia, Aihua Zhang
Renal hypoxia occurs in acute kidney injury (AKI) of various etiologies. Activation of hypoxia-inducible transcription factor (HIF) has been identified as an important mechanism of cellular adaptation to low oxygen. Preconditional HIF activation protects against AKI, suggesting a new approach in AKI treatment. HIF is degraded under normoxic conditions mediated by oxygen-dependent hydroxylation of specific prolyl residues of the regulative α-subunits by HIF prolyl hydroxylases (PHD). FG-4592 is a novel, orally active small-molecule HIF PHD inhibitor for the treatment of anemia in patients with CKD...
March 26, 2018: Clinical Science (1979-)
https://www.readbyqxmd.com/read/29569190/hif-stabilizers-in-the-management-of-renal-anemia-from-bench-to-bedside-to-pediatrics
#9
REVIEW
Dalvir Kular, Iain C Macdougall
Anemia is a common complication of chronic kidney disease (CKD) in adult and pediatric patients. It has traditionally been treated with erythropoietin therapy and iron supplementation, with great success. With the discovery of the major transcription factor hypoxia inducible factor (HIF) for the erythropoietin gene in 1992, molecules were created that inhibit the HIF prolyl-hydroxylase enzyme. This new class of drug-called HIF stabilizers, or HIF prolyl-hydroxylase inhibitors-prevents the proteasomal degradation of HIF-α, thereby inducing upregulation of the erythropoietin gene...
March 22, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/29554879/epidemiology-and-risk-factors-in-ckd-patients-with-pulmonary-hypertension-a-retrospective-study
#10
Qian Zhang, Le Wang, Hongbing Zeng, Yongman Lv, Yi Huang
BACKGROUND: Pulmonary hypertension (PH) is a rare disease often associated with high mortality and is recently recognized as a common complication secondary to chronic kidney disease (CKD). Epidemiological data for this disorder across the spectrum of CKD is poorly understood. METHODS: We retrospectively analyzed 705 CKD patients with complete clinical records from July 2013 to September 2015. All the patients were estimated by echocardiography and PH was defined as pulmonary artery systolic pressure (PASP) > 35 mmHg...
March 20, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29544446/prevalence-treatment-patterns-and-healthcare-resource-utilization-in-medicare-and-commercially-insured-non-dialysis-dependent-chronic-kidney-disease-patients-with-and-without-anemia-in-the-united-states
#11
Wendy L St Peter, Haifeng Guo, Shaum Kabadi, David T Gilbertson, Yi Peng, Trudy Pendergraft, Suying Li
BACKGROUND: Anemia is common in non-dialysis-dependent chronic kidney disease (NDD-CKD) patients, but detailed information on prevalence and treatment is lacking. METHODS: We evaluated anemia prevalence and treatment using two datasets: the Medicare 20% random sample (ages 66-85 years), and the Truven Health MarketScan database (ages 18-63 years). We selected stage 3-5 NDD-CKD patients with and without anemia from both databases during 2011-2013. We evaluated anemia prevalence and treatment (erythropoietin stimulating agents [ESAs], intravenous [IV] iron, red blood cell [RBC] transfusions) following anemia diagnosis during a 1-year baseline period, and healthcare utilization during a 1-year follow-up period...
March 15, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29523750/altered-microbiome-in-chronic-kidney-disease-systemic-effects-of-gut-derived-uremic-toxins
#12
REVIEW
Wei Ling Lau, Javad Savoj, Michael B Nakata, Nosratola D Vaziri
In chronic kidney disease (CKD), influx of urea and other retained toxins exerts a change in the gut microbiome. There is decreased number of beneficial bacteria that produce short-chain fatty acids, an essential nutrient for the colonic epithelium, concurrent with an increase in bacteria that produce uremic toxins such as indoxyl sulphate, p -cresyl sulphate, and trimethylamine-N-oxide (TMAO). Due to intestinal wall inflammation and degradation of intercellular tight junctions, gut-derived uremic toxins translocate into the bloodstream and exert systemic effects...
March 15, 2018: Clinical Science (1979-)
https://www.readbyqxmd.com/read/29513906/does-inflammation-affect-outcomes-in-dialysis-patients
#13
Kristen L Nowak, Michel Chonchol
Chronic, low-grade inflammation is a common comorbid condition in chronic kidney disease (CKD), and particularly in chronic dialysis patients. In this review, we consider the question of whether inflammation affects outcomes in dialysis patients. Levels of proinflammatory cytokines, as well as C-reactive protein, are elevated in chronic dialysis patients. Multiple factors likely contribute to chronic inflammatory activation in kidney disease patients including the uremic milieu, lifestyle and epigenetic influences, infectious and thrombotic events, the dialysis process, and dysbiosis...
March 7, 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29509320/is-there-an-established-hemoglobin-target-range-for-patients-undergoing-chronic-dialysis
#14
Hitesh H Shah, Steven Fishbane
Anemia is a common complication of advanced chronic kidney disease (CKD). Treatment with erythropoiesis-stimulating agents (ESAs) remains a common approach in managing anemia of CKD. The 2012 Kidney Disease Improving Global Outcomes Clinical Practice Guideline for Anemia in CKD suggests avoiding ESA therapy use to maintain Hb level above 11.5 g/dL. However, optimal Hb target range in adult patients undergoing chronic dialysis remains unknown. Clinical studies suggest risks associated with normalization of Hb levels in adult patients with CKD...
March 6, 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29492906/correction-to-epoetin-biosimilars-in-the-treatment-of-chemotherapy-induced-anemia-10-years-experience-gained
#15
Matti Aapro, Andriy Krendyukov, Martin Schiestl, Pere Gascón
Figure 1, HX575 column, 5th box down, which previously read "SC HX575 vs. Eprex® /Erypo® 417 patients with CKD-related anemia" as shown here.
February 28, 2018: BioDrugs: Clinical Immunotherapeutics, Biopharmaceuticals and Gene Therapy
https://www.readbyqxmd.com/read/29485740/discovery-of-molidustat-bay-85-3934-a-small-molecule-oral-hif-prolyl-hydroxylase-hif-ph-inhibitor-for-the-treatment-of-renal-anemia
#16
Hartmut Beck, Mario Jeske, Kai Thede, Friederike Stoll, Ingo Flamme, Metin Akbaba, Jens-Kerim Ergüden, Gunter Karig, Jörg Keldenich, Felix Oehme, Hans-Christian Militzer, Ingo V Hartung, Uwe Thuss
Small molecule inhibitors of hypoxia inducible factor prolyl hydroxylases (HIF-PHs) are currently under clinical development as novel treatment option for chronic kidney disease (CKD) associated anemia. Inhibition of HIF-PH mimics hypoxia and leads to increased EPO expression and subsequently increased erythropoiesis. Herein we describe the discovery, synthesis, SAR and proposed binding mode of novel 2,4-diheteroaryl-1,2-dihydro-3H-pyrazol-3-ones as orally bioavailable HIF-PH inhibitors for the treatment of anemia...
February 27, 2018: ChemMedChem
https://www.readbyqxmd.com/read/29474177/the-cost-and-quality-of-life-of-malaysian-type-2-diabetes-mellitus-patients-with-chronic-kidney-disease-and-anemia
#17
Soraya Azmi, Adrian Goh, Noor Azimah Muhammad, Hizlinda Tohid, Mohd Radzniwan A Rashid
BACKGROUND: Anemia is common among patients with type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD) and an independent risk factor for renal disease progression. Health economic evidence is important in Malaysia and yet cost and quality-of-life (QOL) data are scarce. OBJECTIVES: To investigate prevalence, factors associated with anemia, and cost and QOL among T2DM patients with CKD. Here, we present the estimated 1-year cost and QOL related to anemia in this group...
August 4, 2017: Value in Health Regional Issues
https://www.readbyqxmd.com/read/29465053/erythropoietic-response-to-anaemia-of-dialysis-na%C3%A3-ve-patients-with-chronic-kidney-disease-in-zaria-north-west-nigeria
#18
L G Dogara, A Hassan, S Awwalu, L Okpetu, A D Waziri, A A Babadoko, I B Bosan, H M Muktar
Introduction: Chronic kidney disease (CKD) is a global health problem with an increasing prevalence worldwide. Anemia is one of its consistent and severe hematological complications although its mechanism is not fully elucidated. The primary defect could manifest as serum erythropoietin (sEPO) deficiency or EPO resistance. We set out to determine the erythropoietic response to anemia of patients with CKD and its relationship with their iron status in a cross-sectional descriptive study of 91 patients in various stages of CKD...
February 2018: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/29461006/left-ventricular-geometric-patterns-in-end-stage-kidney-disease-determinants-and-course-over-time
#19
Menso J Nubé, Tiny Hoekstra, Volkan Doganer, Michiel L Bots, Peter J Blankestijn, Marinus van den Dorpel, Otto Kamp, Piet M Ter Wee, Camiel L M de Roij van Zuijdewijn, Muriel P C Grooteman
INTRODUCTION: While concentric left ventricular hypertrophy (cLVH) predominates in non-dialysis-dependent chronic kidney disease (CKD), eccentric left ventricular hypertrophy (eLVH) is most prevalent in dialysis-dependent CKD stage 5 (CKD5D). In these patients, the risk of sudden death is 5× higher than in individuals with cLVH. Currently, it is unknown which factors determine left ventricular (LV) geometry and how it changes over time in CKD5D. METHODS: Data from participants of the CONvective TRAnsport Study who underwent serial transthoracic echocardiography were used...
February 20, 2018: Hemodialysis International
https://www.readbyqxmd.com/read/29459584/study-on-hemoglobin-concentration-in-patient-with-chronic-kidney-disease
#20
A Khanam, A Nessa, K Alam, S Nasreen, R Sultana, F Islam, T Tajkia, R Naznin
In the present study hemoglobin concentration were estimated in chronic kidney diseased patient to observe the frequency of low hemoglobin level in chronic kidney diseased (CKD) patient and to assess the incidence of anaemia. This cross sectional study was carried out in the department of Physiology of Mymensingh Medical College, Mymensingh, Bangladesh from July 2014 to June 2015. For this purpose, total 200 subjects with age ranged from 25 to 60 years were selected and divided into100 healthy persons as control group and 100 CKD patients as study group...
January 2018: Mymensingh Medical Journal: MMJ
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