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https://www.readbyqxmd.com/read/28318656/clinical-characteristics-and-prognosis-of-patients-admitted-for-heart-failure-a-5-year-retrospective-study-of-african-patients
#1
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/28306566/anemia-management-in-chronic-kidney-disease-and-dialysis-a-narrative-review
#2
David Collister, Claudio Rigatto, Navdeep Tangri
PURPOSE OF REVIEW: This review describes the current state of anemia management with erythropoietin (EPO)-stimulating agents and iron supplementation in both chronic kidney disease and dialysis patients, with a focus on novel therapies. RECENT FINDINGS: We review the benefits and risks of EPO-stimulating agents, focusing on health-related quality of life and the uncertainties regarding optimal iron utilization in patients with kidney disease. We discuss novel therapies for iron supplementation including iron-based phosphate binders and dialysate iron delivery as well as alternatives to EPO-stimulating agents including hypoxia-inducible factor prolyl hydroxylase inhibitors...
March 16, 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28302753/erythropoietin-receptor-mediated-molecular-crosstalk-promotes-t-cell-immunoregulation-and-transplant-survival
#3
Carolina Purroy, Robert L Fairchild, Toshiaki Tanaka, William M Baldwin, Joaquin Manrique, Joren C Madsen, Robert B Colvin, Alessandro Alessandrini, Bruce R Blazar, Miguel Fribourg, Chiara Donadei, Umberto Maggiore, Peter S Heeger, Paolo Cravedi
Although spontaneous kidney transplant acceptance/tolerance occurs in mice and occasionally in humans, mechanisms remain unclear. Herein we test the hypothesis that EPO, a hormone predominantly produced by the adult kidney, has immunomodulating properties that are required for spontaneous kidney graft acceptance. In vitro, in a manner dependent on the EPO receptor and CD131 on antigen-presenting cells, EPO induced the secretion of active TGFβ by antigen-presenting cells, which in turn converted naïve CD4(+) T cells into functional Foxp3(+) regulatory T cells (Treg)...
March 16, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28302014/role-of-hepcidin-25-in-chronic-kidney-disease-anemia-and-beyond
#4
Norishi Ueda, Kazuya Takasawa
Iron is an essential element for all living organisms, but produces toxic oxidants. Thus, iron homeostasis is tightly regulated in mammals. Hepcidin-25 (hepcidin) has emerged as a molecule that regulates iron metabolism. Binding of hepcidin to its receptor, ferroportin, inhibits intestinal iron absorption and iron efflux from hepatocytes and macrophages. Decreased hepcidin enhances iron absorption and efflux. Hepcidin could be predictive of iron status and the response to iron supplementation or erythropoietin-stimulating agents...
March 16, 2017: Current Medicinal Chemistry
https://www.readbyqxmd.com/read/28296010/overview-of-iron-metabolism-in-health-and-disease
#5
Som Dev, Jodie L Babitt
Iron is an essential element for numerous fundamental biologic processes, but excess iron is toxic. Abnormalities in systemic iron balance are common in patients with chronic kidney disease and iron administration is a mainstay of anemia management in many patients. This review provides an overview of the essential role of iron in biology, the regulation of systemic and cellular iron homeostasis, how imbalances in iron homeostasis contribute to disease, and the implications for chronic kidney disease patients...
March 15, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28294976/vitamins-and-microelement-bioavailability-in-different-stages-of-chronic-kidney-disease
#6
REVIEW
Magdalena Jankowska, Bolesław Rutkowski, Alicja Dębska-Ślizień
Chronic kidney disease (CKD) predisposes one to either deficiency or toxic excess of different micronutrients. The knowledge on micronutrients-specifically water-soluble vitamins and trace elements-in CKD is very limited. Consequently, current guidelines and recommendations are mostly based on expert opinions or poor-quality evidence. Abnormalities of micronutrient resources in CKD develop for several reasons. Dietary restrictions and anorexia lead to an insufficient micronutrient intake, while diuretics use and renal replacement therapy lead to their excessive losses...
March 15, 2017: Nutrients
https://www.readbyqxmd.com/read/28290095/a-new-approach-to-the-management-of-anemia-in-ckd-patients-a-review-on-roxadustat
#7
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/28284384/autosomal-dominant-tubulointerstitial-kidney-disease
#8
REVIEW
Anthony J Bleyer, Kendrah Kidd, Martina Živná, Stanislav Kmoch
There are 3 major forms of autosomal dominant tubulointerstitial kidney disease (ADTKD): ADTKD due to UMOD mutations, MUC1 mutations, and mutations in the REN gene encoding renin. Lack of knowledge about these conditions contributes to frequent nondiagnosis, but with even limited knowledge, nephrologists can easily obtain a diagnosis and improve patient care. There are 3 cardinal features of these disorders: (1) the conditions are inherited in an autosomal dominant manner and should be considered whenever both a parent and child suffer from kidney disease; the presence of even more affected family members provides further support...
March 2017: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/28263291/iron-suppresses-erythropoietin-expression-via-oxidative-stress-dependent-hypoxia-inducible-factor-2-alpha-inactivation
#9
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
#10
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 3, 2017: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/28248851/acute-kidney-injury-in-patients-with-pulmonary-embolism-a-population-based-cohort-study
#11
Chih-Hsiang Chang, Chung-Ming Fu, Pei-Chun Fan, Shao-Wei Chen, Su-Wei Chang, Chun-Tai Mao, Ya-Chung Tian, Yung-Chang Chen, Pao-Hsien Chu, Tien-Hsing Chen
Acute kidney injury (AKI) is overlooked in patients with pulmonary embolism (PE). Risk factors for and long-term outcomes of this complication remain unknown. This study evaluated the predictors and prognosis of AKI in patients with PE.This retrospective cohort study used Taiwan's National Health Insurance Research Database. We enrolled a total of 7588 patients who were admitted to a hospital for PE from January1997 to December 2011 and administered anticoagulation or thrombolytic agents. All demographic data, risk factors, and outcomes were analyzed...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28248201/intravascular-hemolysis-and-the-pathophysiology-of-sickle-cell-disease
#12
REVIEW
Gregory J Kato, Martin H Steinberg, Mark T Gladwin
Hemolysis is a fundamental feature of sickle cell anemia that contributes to its pathophysiology and phenotypic variability. Decompartmentalized hemoglobin, arginase 1, asymmetric dimethylarginine, and adenine nucleotides are all products of hemolysis that promote vasomotor dysfunction, proliferative vasculopathy, and a multitude of clinical complications of pulmonary and systemic vasculopathy, including pulmonary hypertension, leg ulcers, priapism, chronic kidney disease, and large-artery ischemic stroke. Nitric oxide (NO) is inactivated by cell-free hemoglobin in a dioxygenation reaction that also oxidizes hemoglobin to methemoglobin, a non-oxygen-binding form of hemoglobin that readily loses heme...
March 1, 2017: Journal of Clinical Investigation
https://www.readbyqxmd.com/read/28242135/hypoxia-inducible-factor-prolyl-hydroxylase-inhibitors-a%C3%A2-potential-new-treatment-for-anemia-in-patients-with-ckd
#13
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
#14
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...
February 15, 2017: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/28195648/hematology-and-biochemistry-of-aging-evidence-of-anemia-of-the-elderly-in-old-dogs
#15
Lauren B Radakovich, Stephen C Pannone, Matthew P Truelove, Christine S Olver, Kelly S Santangelo
BACKGROUND: Effects of aging on hematologic and biochemical variables are well described in people. Anemia of the elderly is attributed to iron deficiency, anemia of chronic disease, chronic kidney disease, myelodysplasia, or idiopathic causes. Limited studies have examined these variables in aging dogs, but they have typically examined single breeds in research settings. OBJECTIVE: The objective of this study was to identify differences in CBC and biochemistry values between adult and aged dogs of many breeds...
March 2017: Veterinary Clinical Pathology
https://www.readbyqxmd.com/read/28194476/-diagnosis-and-treatment-of-chronic-kidney-disease
#16
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
#17
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/28182038/study-of-anemia-in-nondialysis-dependent-chronic-kidney-disease-with-special-reference-to-serum-hepcidin
#18
H Goyal, S Mohanty, M Sharma, A Rani
We studied the role of serum hepcidin in anemia of chronic kidney disease (CKD) in a hospital-based cross-sectional study. Serum hepcidin, ferritin, and high-sensitivity C-reactive protein (hsCRP) levels were evaluated in patients of CKD. Hepcidin levels were increased in patients as compared to healthy adults. Hepcidin levels increased as CKD progressed through stage 3-5 (P trend = 0.015) but did not correlate with estimated glomerular filtration rate. Hepcidin correlated positively with ferritin (P < 0...
January 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/28177098/-erythrocyte-abnormalities-and-their-possible-role-in-cardiovascular-complications-of-uremia
#19
Mario Bonomini, Arduino Arduini, Vittorio Sirolli, Natalia Di Pietro, Assunta Pandolfi
Cardiovascular (CV) disease is the leading cause of morbidity and mortality in patients with chronic kidney disease (CKD). Increased incidence of CV events in CKD is related to the presence, besides traditional CV risk factors, of non-traditional CV risk factors associated to renal insufficiency, like anemia. The role of red blood cells (RBC) in uremia has been taken into account almost exclusively in relation to their reduced number. However, RBC in the uremic milieu can acquire several abnormalities which may jeopardize their properties...
January 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28153964/anemia-in-peritoneal-dialysis-patients-iron-repletion-current-and-future-therapies
#20
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
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