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Renal Anemia

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141 papers 100 to 500 followers
By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
Jesse M G Hofman, Michele F Eisenga, Adry Diepenbroek, Ilja M Nolte, Bastiaan van Dam, Ralf Westerhuis, Stephan J L Bakker, Casper F M Franssen, Carlo A J M Gaillard
BACKGROUND: Although the efficacy of iron sucrose (IS) and ferric carboxymaltose (FCM) in treating anemia in hemodialysis (HD) patients has been studied individually, a comparison of these two intravenous iron formulations has not yet been performed in HD patients. METHODS: We performed a retrospective audit on records of 221 stable HD patients from different HD centers in the Netherlands, who were switched from IS to FCM on a 1:1 ratio. To assess the effect of the switch on iron status parameters, data from 3 time points before and 3 time points after the switch were analyzed using linear mixed effects models...
September 20, 2018: BMC Nephrology
Satyendra Kumar Sonkar, Harendra Pratap Singh, Gyanendra Kumar Sonkar, Sant Pandey
Introduction: Anemia is common in Chronic Kidney Disease (CKD) and diabetes is a major leading risk factor for it. In Diabetic Kidney Disease (DKD), it worsens more, which further increases cardiovascular morbidity and mortality. Despite of adequate iron stores anemia persist, which may be due to impaired iron release from body stores that is unable to meet the demand for erythropoiesis (also called reticuloendothelial cell iron blockade). High parathyroid hormone (PTH) along with vitamin D, may be attributable for anemia...
July 2018: Journal of Family Medicine and Primary Care
Michele F Eisenga, Ilja M Nolte, Peter van der Meer, Stephan J L Bakker, Carlo A J M Gaillard
BACKGROUND: Iron deficiency is highly prevalent in chronic kidney disease (CKD) patients. In clinical practice, iron deficiency is defined based on a combination of two commonly used markers, ferritin and transferrin saturation (TSAT). However, no consensus has been reached which cutoffs of these parameters should be applied to define iron deficiency. Hence, we aimed to assess prospectively which cutoffs of ferritin and TSAT performed optimally for outcomes in CKD patients. METHODS: We meticulously analyzed 975 CKD community dwelling patients of the Prevention of Renal and Vascular Endstage Disease prospective study based on an estimated glomerular filtration rate < 60 ml/min/1...
September 12, 2018: BMC Nephrology
Michael Auerbach, Glenn M Chertow, Mitchell Rosner
Ferumoxytol is a superparamagnetic molecule originally developed as a contrast agent for magnetic resonance imaging. Elemental iron is contained within the carbohydrate core and is released slowly after infusion allowing a large dose of iron to be administered in a short period of time. Ferumoxytol, originally approved for iron deficiency in chronic kidney disease, received a broad label for any cause of iron deficiency after oral iron intolerance or in those circumstances when oral iron is ineffective or harmful...
September 6, 2018: Expert Review of Hematology
Aya Shinfuku, Toshiharu Shimazaki, Masanori Fujiwara, Fumihiko Sato, Hirotaka Watase, Takumi Numazaki, Yasunori Kawakita, Masaru Mutoh, Hironori Yamasaki, Noriko Takayama, Sota Kato, Tomohiro Sugimoto, Jinsei Maruyama
BACKGROUND: TP0463518 is a novel hypoxia-inducible factor prolyl hydroxylase inhibitor developed to aid in the treatment of anemia associated with chronic kidney disease (CKD) and is expected to increase erythropoietin (EPO) derived from liver. Two phase I studies were conducted in healthy volunteers (HV) and CKD patients undergoing hemodialysis (i.e., HD patients) or those not undergoing dialysis (i.e., ND patients). METHODS: Pharmacokinetics, pharmacodynamics, and safety profiles of TP0463518 were assessed...
September 3, 2018: American Journal of Nephrology
Rebeca García Agudo, Sami Aoufi Rabih, Pedro González Carro, Francisco Pérez Roldán, Beatriz Proy Vega, Ángel Arias Arias, Fátima Cazalla Cadenas, José María Tenías Burillo, Ana Fernández Rodríguez
INTRODUCTION: Despite the frequency with which anaemia is present in patients with chronic kidney disease (CKD), its relationship with gastrointestinal lesions has not been studied. METHOD: A cross-sectional, analytical, observational study involving one year of recruitment was carried out to determine the prevalence of endoscopic gastrointestinal lesions and associated risk factors in asymptomatic patients with chronic kidney disease stages 1-5 and anaemia who had a positive qualitative immunochemical faecal occult blood test...
August 25, 2018: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
Norishi Ueda, Kazuya Takasawa
Iron deficiency anemia (IDA) is a major problem in chronic kidney disease (CKD), causing increased mortality. Ferritin stores iron, representing iron status. Hepcidin binds to ferroportin, thereby inhibiting iron absorption/efflux. Inflammation in CKD increases ferritin and hepcidin independent of iron status, which reduce iron availability. While intravenous iron therapy (IIT) is superior to oral iron therapy (OIT) in CKD patients with inflammation, OIT is as effective as IIT in those without. Inflammation reduces predictive values of ferritin and hepcidin for iron status and responsiveness to iron therapy...
August 27, 2018: Nutrients
Il Young Kim, June Hyun Kim, Min Jeong Kim, Dong Won Lee, Cheol Gu Hwang, Miyeun Han, Harin Rhee, Sang Heon Song, Eun Young Seong, Soo Bong Lee
PURPOSE: Erythropoietin (EPO) deficiency and resistance to endogenous EPO is an important pathophysiological feature in anemia of chronic kidney disease (CKD). Low 1,25 dihydroxyvitamin D [1,25(OH)2 D] level is known to contribute to anemia of CKD. We aimed to investigate the associations between serum 1,25(OH)2 D and anemia, EPO deficiency, and endogenous EPO resistance in patients with CKD. METHODS: This study included 409 patients with CKD [glomerular filtration rate (GFR) < 60 ml/min/1...
August 22, 2018: International Urology and Nephrology
Kaiping Wang, Jun Wu, Jingya Xu, Saisai Gu, Qiang Li, Peng Cao, Mingming Li, Yu Zhang, Fang Zeng
Given the limited efficacy and potential disadvantages of erythropoiesis-stimulating agents (ESAs) in treating anemia of chronic kidney disease (CKD), the development of better alternative therapies has become a priority. The primary purpose of this study is to investigate the effects of Angelica sinensis polysaccharide (ASP) and its underlying mechanism in the treatment of renal anemia. In the present study, we found that ASP could enhance hypoxic induction of EPO in Hep3B cells, with a mechanism that involved the stabilization of HIF-2α protein...
2018: Frontiers in Pharmacology
Luiz H Arantes, Jeffrey Crawford, Pere Gascon, Mark Latymer, Vincent Launay-Vacher, Catherine Rolland, Florian Scotte, Jay Wish
Erythropoiesis-stimulating agents (ESAs) are man-made forms of erythropoietin used in the treatment of anemia. This quick-scoping review of systematic literature reviews (SLRs) was conducted to define the clinical, economic, and health-related quality of life (HRQoL) outcomes for short-acting and long-acting ESAs in patients with chronic kidney disease-induced anemia (CKD-IA) and patients with chemotherapy-induced anemia (CIA). Embase, Medline, and the Cochrane Database of Systematic Reviews were searched from their establishment until October 2017...
September 2018: Critical Reviews in Oncology/hematology
Toshihide Hayashi, Yuri Tanaka, Masaki Iwasaki, Hiroki Hase, Hiroyuki Yamamoto, Yasuhiro Komatsu, Ryoichi Ando, Masato Ikeda, Daijo Inaguma, Toshifumi Sakaguchi, Toshio Shinoda, Fumihiko Koiwa, Shigeo Negi, Toshihiko Yamaka, Takashi Shigematsu, Nobuhiko Joki
OBJECTIVES: High prevalence of iron deficiency (ID) and cardiomyopathy have been observed in patients with end-stage kidney disease (ESKD). Our objective was to clarify associations between ID and cardiac remodeling in patients with ESKD. DESIGN AND METHODS: A cross-sectional study was conducted using 1974 Japanese patients with ESKD at the initiation of maintenance dialysis. Levels of hemoglobin (Hb), iron status, and cardiac enlargement as assessed by the cardiothoracic ratio (CTR) were determined immediately before the first hemodialysis session...
August 7, 2018: Journal of Renal Nutrition
Michael E Brier, Adam E Gaweda, George R Aronoff
Substantial progress has been made in the application of computer-driven methods to provide erythropoietic dosing information for patients with anemia resulting from chronic kidney disease. Initial solutions were simply computerized versions of traditional paper-based anemia management protocols. True personalization was achieved through the use of advanced modeling techniques such as artificial neural networks, physiologic models, and feedback control systems. The superiority of any one technique over another has not been determined, but all methods have shown an advantage in at least one area over the traditional paper expert system used by most dialysis facilities...
July 2018: Seminars in Nephrology
Valeria Cernaro, Giuseppe Coppolino, Luca Visconti, Laura Rivoli, Antonio Lacquaniti, Domenico Santoro, Antoine Buemi, Saverio Loddo, Michele Buemi
Erythropoiesis is triggered by hypoxia and is strictly regulated by hormones, growth factors, cytokines, and vitamins to ensure an adequate oxygen delivery to all body cells. Abnormalities in one or more of these factors may induce different kinds of anemia requiring different treatments. A key player in red blood cell production is erythropoietin. It is a glycoprotein hormone, mainly produced by the kidneys, that promotes erythroid progenitor cell survival and differentiation in the bone marrow and regulates iron metabolism...
August 6, 2018: Medicinal Research Reviews
Dengpiao Xie, Jianting Wang, Xinping Wu, Mingquan Li
BACKGROUND: The efficacy of daprodustat for the treatment of anemic patients with chronic kidney disease (CKD) remains controversial. The aim of the study is to perform a meta-analysis of randomized controlled trials to evaluate the efficacy and safety of daprodustat for anemic patients with chronic kidney disease. METHODS: We searched Medline, Embase, Science Citation Index, Cochrane Central Register of Controlled Trials, and Clinical Trial Registries for randomized controlled trials comparing daprodustat with placebo for anemic patients with CKD...
August 2, 2018: International Urology and Nephrology
Shuta Motonishi, Kentaro Tanaka, Takashi Ozawa
BACKGROUND: While iron deficiency (ID) is a frequent cause of anemia in hemodialysis patients, the clinical impact of ID without anemic level of hemoglobin remains unclear. As such, this study was designed to clarify the manifestations of ID itself in subjects on hemodialysis. METHODS: Maintenance hemodialysis patients achieving target hemoglobin levels (≥ 10.0g/dL) under treatment in our clinic were stratified for comparison from three perspectives: ID (transferrin saturation [TSAT] < 20% or ferritin < 100ng/mL) vs non-ID, level of TSAT (< or ≥ 20%), and level of serum ferritin concentration (< or ≥ 100ng/mL)...
2018: PloS One
Sho Hasegawa, Tetsuhiro Tanaka, Masaomi Nangaku
PURPOSE OF REVIEW: Small-molecule inhibitors of prolyl hydroxylase domain enzymes (PHD inhibitors) are novel renal anemia therapies that increase endogenous erythropoietin (EPO) production by stabilizing hypoxia-inducible factor (HIF). This review summarizes recent findings and future perspectives of PHD inhibitors (HIF stabilizers) in chronic kidney disease (CKD)-associated anemia. RECENT FINDINGS: Clinical trials have demonstrated that HIF stabilizers effectively increase hemoglobin levels of both nondialysis and dialysis CKD patients without causing serious adverse effects...
September 2018: Current Opinion in Nephrology and Hypertension
Daigo Kamei, Michio Mineshima, Misao Tsukada, Naoko Miwa, Norio Hanafusa, Ken Tsuchiya
BACKGROUND: Serum ferritin is one of the most important and widely used markers of iron metabolism, and is a recommended standard index of iron dynamics in guidelines for renal anemia in many countries. However, serum ferritin measurement has several disadvantages. For example, it is prone to being influenced by underlying disease, and there is considerable systematic bias among different methods of measurement. SUMMARY: Systematic bias affects not only the measurement results, but also the therapeutic strategy to be used in accordance with the relevant guidelines, and consequently the cost of medical treatment...
2018: Contributions to Nephrology
Takahiro Kuragano, Takeshi Nakanishi
Recent large clinical trials have reported that despite the maintenance of target hemoglobin (Hb) levels, higher doses of erythropoiesis-stimulating agents (ESAs) and/or iron preparations are significantly associated with higher risks of adverse events and death in maintenance hemodialysis (MHD) patients. Higher doses of ESAs have been demonstrated to result in a higher risk for cardiovascular disease due to elevated blood pressure or increased thrombogenicity. In addition, a high dose of iron might enhance inflammatory responses to infection and impair the phagocytic function of neutrophils...
2018: Contributions to Nephrology
Inder S Anand, Pankaj Gupta
Anemia and iron deficiency are important and common comorbidities that often coexist in patients with heart failure. Both conditions, together or independently, are associated with poor clinical status and worse outcomes. Whether anemia and iron deficiency are just markers of heart failure severity or whether they mediate heart failure progression and outcomes and therefore should be treated is not entirely clear. Treatment of anemia in patients with heart failure with erythropoiesis-stimulating agents has been evaluated intensively during the past several years...
July 3, 2018: Circulation
Sundararaman Swaminathan
BACKGROUND: Iron is critical for fundamental biologic functions such as cell division and mitochondrial electron transport. However, by the virtue of its ability to donate electrons, iron is probably the most effective oxidant in biologic systems. SUMMARY: To avoid damage from iron-mediated oxidative injury or ferroptosis, multiple defense mechanisms exist including iron binding proteins and robust glutathione-dependent intracellular pathways. Hepcidin, through its ability to sequester iron within macrophages and induce H-ferritin, serves as an endogenous protective molecule against ferroptosis...
July 6, 2018: Nephron
2018-07-11 08:02:19
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