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anemia treatment in ckd

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https://www.readbyqxmd.com/read/28321324/choosing-wisely-the-canadian-society-of-nephrology-s-list-of-5-items-physicians-and-patients-should-question
#1
Emilie Chan, Brenda Hemmelgarn, Scott Klarenbach, Braden Manns, Reem Mustafa, Gihad Nesrallah, Rory McQuillan
PURPOSE OF REVIEW: The purpose of this review is to contribute to the Choosing Wisely Canada campaign and develop a list of 5 items for nephrology health care professionals and patients to re-evaluate based on evidence that they are overused or misused. SOURCES OF INFORMATION: A working group was formed from the Canadian Society of Nephrology (CSN) Clinical Practice Guidelines Committee. This working group sequentially used a multistage Delphi method, a survey of CSN members, a modified Delphi process, and a comprehensive literature review to determine 10 candidate items representing potentially ineffective care in nephrology...
2017: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/28318656/clinical-characteristics-and-prognosis-of-patients-admitted-for-heart-failure-a-5-year-retrospective-study-of-african-patients
#2
Kwadwo Osei Bonsu, Isaac Kofi Owusu, Kwame Ohene Buabeng, Daniel D Reidpath, Amudha Kadirvelu
BACKGROUND: Mortality associated with heart failure (HF) remains high. There are limited clinical data on mortality among HF patients from African populations. We examined the clinical characteristics, long-term outcomes, and prognostic factors of African HF patients with preserved, mid-range or reduced left ventricular ejection fraction (LVEF). METHODS AND RESULTS: We conducted a retrospective longitudinal cohort study of individuals aged ≥18years discharged from first HF admission between January 1, 2009 and December 31, 2013 from the Cardiac Clinic, Directorate of Medicine of the Komfo Anokye Teaching Hospital, Ghana...
March 6, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28290095/a-new-approach-to-the-management-of-anemia-in-ckd-patients-a-review-on-roxadustat
#3
REVIEW
Kimberly Becker, Maha Saad
This article informs the reader of the current information available on a novel therapeutic agent and new class of drug for the treatment of anemia. The data show promising results for alternative erythropoietin-stimulating agents and offers a time line of when Phase III data will be available. The information on this new drug and new drug class will change how nephrologists approach treating anemia within their patients.
March 13, 2017: Advances in Therapy
https://www.readbyqxmd.com/read/28263291/iron-suppresses-erythropoietin-expression-via-oxidative-stress-dependent-hypoxia-inducible-factor-2-alpha-inactivation
#4
Keisuke Oshima, Yasumasa Ikeda, Yuya Horinouchi, Hiroaki Watanabe, Hirofumi Hamano, Yoshitaka Kihira, Seiji Kishi, Yuki Izawa-Ishizawa, Licht Miyamoto, Tasuku Hirayama, Hideko Nagasawa, Keisuke Ishizawa, Koichiro Tsuchiya, Toshiaki Tamaki
Renal anemia is a major complication in chronic kidney disease (CKD). Iron supplementation, as well as erythropoiesis-stimulating agents, are widely used for treatment of renal anemia. However, excess iron causes oxidative stress via the Fenton reaction, and iron supplementation might damage remnant renal function including erythropoietin (EPO) production in CKD. EPO gene expression was suppressed in mice following direct iron treatment. Hypoxia-inducible factor-2 alpha (HIF-2α), a positive regulator of the EPO gene, was also diminished in the kidney of mice following iron treatment...
March 6, 2017: Laboratory Investigation; a Journal of Technical Methods and Pathology
https://www.readbyqxmd.com/read/28256075/the-use-of-darbepoetin-to-stimulate-erythropoiesis-in-the-treatment-of-anemia-of-chronic-kidney-disease-in-dogs
#5
E H Fiocchi, L D Cowgill, D C Brown, J E Markovich, S Tucker, M A Labato, M B Callan
BACKGROUND: Darbepoetin alfa (darbepoetin) is an erythropoiesis-stimulating agent used for the treatment of anemia secondary to chronic kidney disease (CKD) in dogs, but reports describing response are lacking. HYPOTHESIS/OBJECTIVES: To evaluate the effectiveness of darbepoetin in dogs with anemia secondary to CKD, dosing protocols, and adverse events. ANIMALS: Thirty-three client-owned dogs with naturally occurring CKD, including 26 with comorbidities...
March 2017: Journal of Veterinary Internal Medicine
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/28198040/blood-transfusions-in-dogs-and-cats-receiving-hemodialysis-230-cases-june-1997-september-2012
#7
C Langston, A Cook, A Eatroff, E Mitelberg, S Chalhoub
BACKGROUND: Multiple factors exist that contribute to anemia in dogs and cats receiving hemodialysis, can necessitate transfusion. OBJECTIVES: To describe blood product usage in dogs and cats with acute and chronic kidney disease that were treated with intermittent hemodialysis to determine risk factors associated with the requirement for blood product transfusion. ANIMALS: 83 cats and 147 dogs undergoing renal replacement therapy at the Animal Medical Center for acute or chronic kidney disease...
March 2017: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/28194476/-diagnosis-and-treatment-of-chronic-kidney-disease
#8
M Girndt
Chronic kidney disease is defined by decreased glomerular filtration rate or proteinuria. Diabetic nephropathy and hypertensive renal damage are responsible for the majority of cases. The initiation of therapy has to consider if causal treatment of the underlying disease is possible and indicated. In all patients, even if specific treatment is not possible, therapy should aim at reducing progression of kidney failure. Chronic kidney diseases tend to intrinsic deterioration that persists after cessation of the causative damaging pathomechanism...
February 13, 2017: Der Internist
https://www.readbyqxmd.com/read/28186645/occult-gastrointestinal-bleeding-is-a-common-finding-in-dogs-with-chronic-kidney-disease
#9
Leandro Z Crivellenti, Sofia Borin-Crivellenti, Kristi L Fertal, Catarina M Contin, Caroline M J Miranda, Aureo E Santana
BACKGROUND: The risk of occult gastrointestinal bleeding (OGIB) is known to be increased among human dialysis patients suffering from end-stage renal disease. However, there are no studies to date that investigate the incidence of OGIB in either dogs or people with chronic kidney disease (CKD), irrespective of dialysis. OBJECTIVES: The purpose of the study was to determine whether the incidence of OGIB is greater in dogs with CKD as compared to a control population, and if this pathology is associated with changes in serum variables related to iron metabolism...
February 10, 2017: Veterinary Clinical Pathology
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/28142147/history-of-erythropoiesis-stimulating-agents-the-development-of-biosimilars-and-the-future-of-anemia-treatment-in-nephrology
#11
Kamyar Kalantar-Zadeh
BACKGROUND: Exogenous replacement of erythropoietin (EPO) by recombinant human EPO has been considered a standard of care for the treatment of anemia in patients with chronic kidney disease for more than 20 years. Genetically engineered biologic proteins derived from human, animal, or microorganism sources are a major area of growth in modern medical care, accounting for one-third of new drug approvals in the past decade. Despite benefit to patients, the use of biologics comes at a significant cost, representing one of the fastest growing segments of strained healthcare budgets around the world...
2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/28137221/methoxy-polyethylene-glycol-epoetin-beta-as-a-novel-erythropoiesis-stimulating-agent-with-possible-nephroprotective-and-cardiovascular-protective-effects-in-non-dialysis-chronic-kidney-disease-patients
#12
Bartnicki Piotr, Stępień Mariusz, Rysz Jacek
Chronic kidney disease (CKD) is an important health problem, because of unsuccessful outcomes such as CKD progression to end stage renal disease and high risk of cardiovascular disease (CVD). Anemia, associated with CKD, is considered a non-traditional risk factor for CVD which may contribute to faster CKD progression. Anemia treatment with erythropoiesis-stimulating agents (ESAs) seems to exert non-hematopoietic effects on different tissues and organs, including cardiovascular system and kidneys. On the other hand, clinical use of high doses of short-acting ESAs and higher target hemoglobin level were associated with higher risk of CVD...
January 26, 2017: Current Pharmaceutical Biotechnology
https://www.readbyqxmd.com/read/28135334/relative-incidence-of-acute-adverse-events-with-ferumoxytol-compared-to-other-intravenous-iron-compounds-a-matched-cohort-study
#13
James B Wetmore, Eric D Weinhandl, Jincheng Zhou, David T Gilbertson
Concerns persist about adverse reactions to intravenous (IV) iron. We aimed to determine the relative safety of ferumoxytol compared to other IV iron compounds. This retrospective cohort study with propensity-score matching for patients and drug doses used the Medicare 20% random sample to identify patients (1) without chronic kidney disease (non-CKD) and (2) with non-dialysis-dependent chronic kidney disease (NDD-CKD) who received a first dose of IV iron in 2010-2012. Exposures were ferumoxytol, iron sucrose, sodium ferric gluconate, or iron dextran...
2017: PloS One
https://www.readbyqxmd.com/read/28118622/targeting-hypoxia-inducible-factors-for-the-treatment-of-anemia-in-chronic-kidney-disease-patients
#14
Francesco Locatelli, Steven Fishbane, Geoffrey A Block, Iain C Macdougall
BACKGROUND: Anemia, a common complication of chronic kidney disease (CKD), has previously been attributed primarily to decreased production of erythropoietin. More recently, it has become apparent that the etiology of anemia involves several other factors, most notably dysfunctional iron metabolism, mediated via increased hepcidin activity and reduced clearance. Current management of anemia in patients with advanced CKD is based on erythropoiesis-stimulating agents and iron supplementation, along with red blood cell transfusions when necessary; however, safety considerations associated with these therapies highlight the need to pursue alternative treatment options targeting other mechanisms such as hypoxia-inducible factors (HIFs) that act as central regulators of erythropoiesis by coordinating a series of graded hypoxic responses...
2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/28110585/anemia-in-the-elderly-a-consequence-of-aging
#15
Racha Halawi, Hassan Moukhadder, Ali Taher
Anemia in the elderly is a common finding that is associated with a poorer quality of life, worse outcomes, and increased mortality. While this entity is frequently overlooked, there is often an underlying cause that is correctable. Areas covered: In this review, we shed light on the prevalence of anemia in the elderly population, review the most common causes, particularly iron deficiency anemia and anemia of chronic disease, and describe the available treatment modalities. When a clear etiology for the anemia is ruled-out, the term unexplained anemia may be utilized; while still an under-explored field, one of the underlying pathophysiological mechanisms appears to be associated with an age-related inflammatory process...
January 21, 2017: Expert Review of Hematology
https://www.readbyqxmd.com/read/28077085/erythropoiesis-stimulating-agents-and-reno-protection-a-meta-analysis
#16
Steve Elliott, Dianne Tomita, Zoltan Endre
BACKGROUND: Erythropoiesis stimulating agents (ESAs) were proposed to enhance survival of renal tissues through direct effects via activation of EPO receptors on renal cells resulting in reduced cell apoptosis, or indirect effects via increased oxygen delivery due to increased numbers of Hb containing red blood cells. Thus through several mechanisms there may be benefit of ESA administration on kidney disease progression and kidney function in renal patients. However conflicting ESA reno-protection outcomes have been reported in both pre-clinical animal studies and human clinical trials...
January 11, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28044233/management-of-secondary-hyperparathyroidism-how-and-why
#17
REVIEW
Hirotaka Komaba, Takatoshi Kakuta, Masafumi Fukagawa
Secondary hyperparathyroidism (SHPT) is a common complication in chronic kidney disease. Currently, various treatment options are available, including vitamin D receptor activators, cinacalcet hydrochloride, and parathyroidectomy. These treatment options have contributed to the successful control of SHPT, and recent clinical studies have provided evidence suggesting that effective treatment of SHPT leads to improved survival. Although bone disease is the most widely recognized consequence of SHPT and remains a major target for treatment of SHPT, there is increasing evidence that parathyroid hormone (PTH) and fibroblast growth factor 23 (FGF23), both of which are markedly elevated in SHPT, have multiple adverse effects on extraskeletal tissues...
March 2017: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/28042744/influence-of-acute-and-chronic-kidney-failure-in-rats-on-the-disposition-and-pharmacokinetics-of-zyan1-a-novel-prolyl-hydroxylase-inhibitor-for-the-treatment-of-chronic-kidney-disease-induced-anemia
#18
Harilal Patel, Amit Arvind Joharapurkar, Vrajesh Bhaskarbhai Pandya, Vishal Jagjivanbhai Patel, Samadhan Govind Kshirsagar, Prakash Patel, Bhavesh Gevriya, Mukul R Jain, Nuggehally R Srinivas, Pankaj Ramanbhai Patel, Ranjit C Desai
1. ZYAN1 is a prolyl hydroxylase inhibitor in clinical development for treatment of anemia associated with chronic kidney disease (CKD). We evaluated the effect of acute and chronic kidney impairment on the pharmacokinetics of ZYAN1 in rat models. 2. Cisplatin (2.5, 5 and 7.5 mg/kg) was used to induce acute kidney injury (AKI), and five-sixth and total nephrectomy was used to induce chronic kidney injury (CKI) in male Wistar rats. All groups received a single 15 mg/kg oral dose of ZYAN1. Blood/urine samples were analyzed for ZYAN1 to assess peak concentration (Cmax), area under the concentration-time curve (AUCinf), total body clearance (CL/F) and elimination half-life (T1/2)...
January 19, 2017: Xenobiotica; the Fate of Foreign Compounds in Biological Systems
https://www.readbyqxmd.com/read/28013381/pilot-study-of-the-effect-of-cholecalciferol-supplementation-on-hepcidin-in-children-with-chronic-kidney-disease-results-of-the-d-fense-trial
#19
Meredith A Atkinson, Stephen P Juraschek, Michael S Bertenthal, Barbara Detrick, Susan L Furth, Edgar R Miller
BACKGROUND: Hepcidin is a key mediator of the anemia of chronic kidney disease (CKD). There is emerging evidence that 25-hydroxyvitamin D (25D) regulates hepcidin production. METHODS: A randomized controlled trial of daily vitamin D supplementation for 12 weeks was performed with the aim to test the effects of 4000 versus 400 IU of cholecalciferol on serum hepcidin levels in children with non-dialysis CKD recruited at a tertiary care children's hospital. Hepcidin was quantified using a validated competitive enzyme-linked immunosorbent assay...
December 24, 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/27994599/possible-inhibitory-effect-of-erythropoiesis-stimulating-agents-at-the-predialysis-stage-on-early-phase-coronary-events-after-hemodialysis-initiation
#20
Masato Nishimura, Keitaro Watanabe, Yuki Kitamura, Takao Nagashima, Toshiko Tokoro, Toru Takatani, Nodoka Sato, Satoru Yamazaki, Tetsuya Hashimoto, Hiroyuki Kobayashi, Toshihiko Ono
BACKGROUND: We examined whether the use of erythropoiesis-stimulating agents (ESAs) to correct anemia at the predialysis stage could inhibit early-phase coronary events after hemodialysis initiation. METHODS: We enrolled 242 patients with chronic kidney disease who had received continued medical treatments and initiated maintenance hemodialysis from 1 September 2000 to 31 December 2014 at Toujinkai Hospital. Patients with a previous history of blood transfusion or any cardiovascular events or interventions were excluded...
November 2016: Cardiorenal Medicine
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