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Renal Anemia

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63 papers 100 to 500 followers
By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
https://www.readbyqxmd.com/read/29227261/clinical-features-of-therapy-of-anemia-and-the-significance-of-its-fluctuation-in-the-development-of-anemia-in-dialysis-patients
#1
E Lapina, M Batiushin, V Terentiev, M Gasanov, A Gasanova
The aim of our study was to examine the features of therapy of anemia, and the influence of fluctuation in dose of antianemic drugs on hemoglobin levels in dialysis patients. The study included 100 patients with chronic kidney disease stage 5D receiving hemodialysis, mean age was 53,4±15,8 years. The clinical and anamnestic data were studied and laboratory tests were performed in all patients. The correlation between hemoglobin level and fluctuations in dose of antianemic drugs for 12 months: erythropoietin (R= -0,51, p=0,004) and iron (R= -0,46, p=0,01) was determined...
November 2017: Georgian Medical News
https://www.readbyqxmd.com/read/29092739/erythropoietic-response-to-oral-iron-in-patients-with-nondialysis-dependent-chronic-kidney-disease-in-the-find-ckd-trial%C3%A2
#2
Iain C Macdougall, Andreas H Bock, Fernando Carrera, Kai-Uwe Eckardt, Carlo Gaillard, David Van Wyck, Yvonne Meier, Sylvain Larroque, Amandine Perrin, Simon D Roger
AIMS: To evaluate erythropoietic response rates to oral iron over time in iron-deficient anemic patients with nondialysis-dependent chronic kidney disease (ND-CKD). MATERIALS AND METHODS: FIND-CKD was a 1-year, randomized, multicenter trial of iron therapy in patients with ND-CKD, anemia, and iron deficiency, without erythropoiesis-stimulating agent (ESA) therapy. Patients with active infection or C-reactive protein > 20 mg/L were excluded. In this post-hoc analysis, response was defined as ≥ 1 g/dL increase in hemoglobin (Hb) from baseline, before initiation of alternative anemia therapy (i...
October 26, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28904872/treatment-of-renal-anemia-erythropoiesis-stimulating-agents-and-beyond
#3
REVIEW
Patrick Biggar, Gheun-Ho Kim
Anemia, complicating the course of chronic kidney disease, is a significant parameter, whether interpreted as subjective impairment or an objective prognostic marker. Renal anemia is predominantly due to relative erythropoietin (EPO) deficiency. EPO inhibits apoptosis of erythrocyte precursors. Studies using EPO substitution have shown that increasing hemoglobin (Hb) levels up to 10-11 g/dL is associated with clinical improvement. However, it has not been unequivocally proven that further intensification of erythropoiesis stimulating agent (ESA) therapy actually leads to a comprehensive benefit for the patient, especially as ESAs are potentially associated with increased cerebro-cardiovascular events...
September 2017: Kidney Research and Clinical Practice
https://www.readbyqxmd.com/read/28612425/iron-deficiency-across-chronic-inflammatory-conditions-international-expert-opinion-on-definition-diagnosis-and-management
#4
REVIEW
Maria Domenica Cappellini, Josep Comin-Colet, Angel de Francisco, Axel Dignass, Wolfram Doehner, Carolyn S P Lam, Iain C Macdougall, Gerhard Rogler, Clara Camaschella, Rezan Kadir, Nicholas J Kassebaum, Donat R Spahn, Ali T Taher, Khaled M Musallam
Iron deficiency, even in the absence of anemia, can be debilitating, and exacerbate any underlying chronic disease, leading to increased morbidity and mortality. Iron deficiency is frequently concomitant with chronic inflammatory disease; however, iron deficiency treatment is often overlooked, partially due to the heterogeneity among clinical practice guidelines. In the absence of consistent guidance across chronic heart failure, chronic kidney disease and inflammatory bowel disease, we provide practical recommendations for iron deficiency to treating physicians: definition, diagnosis, and disease-specific diagnostic algorithms...
October 2017: American Journal of Hematology
https://www.readbyqxmd.com/read/28528999/clinical-management-of-iron-deficiency-anemia-in-adults-systemic-review-on-advances-in-diagnosis-and-treatment
#5
REVIEW
Lucia De Franceschi, Achille Iolascon, Ali Taher, Maria Domenica Cappellini
Global burden disease studies point out that one of the top cause-specific anemias is iron deficiency (ID). Recent advances in knowledge of iron homeostasis have shown that fragile patients are a new target population in which the correction of ID might impact their morbidity, mortality and quality of life. We did a systematic review using specific search strategy, carried out the review of PubMed database, Cochrane Database of systemic reviews and international guidelines on diagnosis and clinical management of ID from 2010 to 2016...
July 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28507005/perspective-what-makes-it-so-difficult-to-mitigate-worldwide-anemia-prevalence
#6
Klaus Schümann, Noel W Solomons
Anemia can be related to decreased production or increased loss of erythrocytes, or both, leading to many underlying and often overlapping causes. A largely cereal-based diet with plenty of phytates, polyphenols, and other ligands that inhibit intestinal iron absorption predominated in preindustrial Europe and predominates in present-day developing countries alike. In both situations, we find poor hygienic conditions, which frequently lead to anemia of inflammation. The large number of possible causes and their interaction shows why it is so difficult to mitigate anemia prevalence...
May 2017: Advances in Nutrition
https://www.readbyqxmd.com/read/28487874/administration-of-pentoxifylline-to-improve-anemia-of-hemodialysis-patients
#7
Heshmatolah Shahbazian, Ali Ghorbani, Azita Zafar-Mohtashami, Abdolreza Balali, Armaghan AleAli, Gholam Reza Lashkarara
Introduction: One of the most important causes of erythropoietin-resistant anemia in end-stage renal disease (ESRD) patients is increased levels of inflammatory cytokines. Objectives: In this study pentoxifylline, an anti-inflammatory and anti-cytokine drug, with no significant side effects was used to manage anemia in ESRD patients. Patients and Methods: Thirty-nine ESRD patients with erythropoietin-resistant anemia were assigned to two groups, the treatment and the control groups. In treatment group, 19 patients received erythropoietin, venofer and pentoxifylline for 6 months...
2017: Journal of Renal Injury Prevention
https://www.readbyqxmd.com/read/28468297/hypoxia-hif-and-associated-signaling-networks-in-chronic-kidney-disease
#8
REVIEW
Jing Liu, Qingqing Wei, Chunyuan Guo, Guie Dong, Yu Liu, Chengyuan Tang, Zheng Dong
The pathogenesis of chronic kidney disease (CKD) is complex and apparently multifactorial. Hypoxia or decrease in oxygen supply in kidney tissues has been implicated in CKD. Hypoxia inducible factors (HIF) are a small family of transcription factors that are mainly responsive to hypoxia and mediate hypoxic response. HIF plays a critical role in renal fibrosis during CKD through the modulation of gene transcription, crosstalk with multiple signaling pathways, epithelial-mesenchymal transition, and epigenetic regulation...
April 30, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28370957/safety-of-intravenous-iron-in-hemodialysis-patients
#9
REVIEW
Xiaojuan Li, Abhijit V Kshirsagar, M Alan Brookhart
Among end-stage renal disease patients maintained by hemodialysis, anemia has been managed primarily through erythropoiesis-stimulating agents (ESAs) and intravenous (IV) iron. Following concerns about the cardiovascular (CV) safety of ESAs and changes in the reimbursement policies in Medicare's ESRD program, the use of IV iron has increased. IV iron supplementation promotes hemoglobin production and reduces ESA requirements, yet there exists relatively little evidence on the long-term safety of iron supplementation in hemodialysis patients...
June 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28371203/the-available-intravenous-iron-formulations-history-efficacy-and-toxicology
#10
REVIEW
Michael Auerbach, Iain Macdougall
A number of intravenous iron formulations have been developed over the past 65 years which rely on dextran or other compounds to prevent uncontrolled release of free iron to the circulation. High molecular weight dextran was associated with a number of serious adverse reactions and was removed from markets worldwide in 2009. The preponderance of published evidence suggests that the formulations of parenteral iron currently available in the United States, including low molecular weight iron dextran, are all safe and effective and there are no major, clinically important differences among them in terms of either efficacy or safety...
June 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28096133/regulation-of-the-iron-homeostatic-hormone-hepcidin
#11
REVIEW
Veena Sangkhae, Elizabeta Nemeth
Iron is required for many biological processes but is also toxic in excess; thus, body iron balance is maintained through sophisticated regulatory mechanisms. The lack of a regulated iron excretory mechanism means that body iron balance is controlled at the level of absorption from the diet. Iron absorption is regulated by the hepatic peptide hormone hepcidin. Hepcidin also controls iron release from cells that recycle or store iron, thus regulating plasma iron concentrations. Hepcidin exerts its effects through its receptor, the cellular iron exporter ferroportin...
January 2017: Advances in Nutrition
https://www.readbyqxmd.com/read/28082519/effects-of-ferric-citrate-in-patients-with-nondialysis-dependent-ckd-and-iron-deficiency-anemia
#12
RANDOMIZED CONTROLLED TRIAL
Steven Fishbane, Geoffrey A Block, Lisa Loram, John Neylan, Pablo E Pergola, Katrin Uhlig, Glenn M Chertow
Iron deficiency anemia is common and consequential in nondialysis-dependent CKD (NDD-CKD). Efficacy and tolerability of conventional oral iron supplements are mixed; intravenous iron administration associates with finite but important risks. We conducted a randomized double-blind clinical trial in adults with NDD-CKD and iron deficiency anemia to compare the safety and efficacy of oral ferric citrate (n=117) and placebo (n=115). The primary end point was the proportion of patients who achieved a ≥1.0 g/dl increase in hemoglobin at any time during a 16-week randomized period...
June 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28077085/erythropoiesis-stimulating-agents-and-reno-protection-a-meta-analysis
#13
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/28049235/the-prevalence-and-management-of-anemia-in-chronic-kidney-disease-patients-result-from-the-korean-cohort-study-for-outcomes-in-patients-with-chronic-kidney-disease-know-ckd
#14
Sang Ryol Ryu, Sue K Park, Ji Yong Jung, Yeong Hoon Kim, Yun Kyu Oh, Tae Hyun Yoo, Suah Sung
Anemia is a common and significant complication of chronic kidney disease (CKD). However, its prevalence and current management status has not been studied thoroughly in Korea. We examined the prevalence of anemia, its association with clinical and laboratory factors, and utilization of iron agents and erythropoiesis stimulating agents using the baseline data from the large-scale CKD cohort in Korea. We defined anemia when hemoglobin level was lower than 13.0 g/dL in males and 12.0 g/dL in females, or received by erythropoiesis stimulating agents...
February 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/27604984/intravenous-iron-administration-strategies-and-anemia-management-in-hemodialysis-patients
#15
Wieneke M Michels, Bernard G Jaar, Patti L Ephraim, Yang Liu, Dana C Miskulin, Navdeep Tangri, Deidra C Crews, Julia J Scialla, Tariq Shafi, Stephen M Sozio, Karen Bandeen-Roche, Courtney J Cook, Klemens B Meyer, L Ebony Boulware
Background: The effect of maintenance intravenous (IV) iron administration on subsequent achievement of anemia management goals and mortality among patients recently initiating hemodialysis is unclear. Methods: We performed an observational cohort study, in adult incident dialysis patients starting on hemodialysis. We defined IV administration strategies over a 12-week period following a patient's initiation of hemodialysis; all those receiving IV iron at regular intervals were considered maintenance, and all others were considered non-maintenance...
January 1, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/27428164/spectrum-of-anemia-after-kidney-transplantation-pathophysiology-and-therapeutic-implications
#16
REVIEW
Oluwatoyin F Bamgbola
The prevalence of anemia in the first month after transplant is 70%-80%. The rate declines to 30%-40% at 3 months and 20% by 12 months. Its occurrence is influenced by the quality of the transplanted organ, bone marrow regenerative capacity, amount of surgical blood loss, and increased iron recycling. There is also a blunted response by oxidative inflammation to the effectiveness of supranormal levels of erythropoietin (EPO) release during ischemic-reperfusion allograft injury. The prevalence rate of late-onset post-transplant anemia (PTA) is 30%-50%...
October 2016: Clinical Transplantation
https://www.readbyqxmd.com/read/27455803/-the-role-of-zinc-in-chronic-kidney-disease
#17
Tatsuo Fukushima
Renal anemia is one of the most important complication as a cause of cardiovascular event in patients with chronic kidney disease (CKD). The status of renal anemia has been ameliorated by using recombinant human erythropoietin (EPO), however, the EPO resistant anemia is sometimes seen in high stage CKD patients. Heavy metal deficiency including zinc deficiency is one of the cause of EPO resistant anemia. Recently, it is reported that zinc deficiency is seen in patients with CKD. In this article, we describe zinc deficiency in patients with CKD...
July 2016: Nihon Rinsho. Japanese Journal of Clinical Medicine
https://www.readbyqxmd.com/read/27318465/novel-masters-of-erythropoiesis-hypoxia-inducible-factors-and-recent-advances-in-anemia-of-renal-disease
#18
REVIEW
Yalcin Solak, Mustafa Cetiner, Dimitrie Siriopol, Kayhan Tarim, Baris Afsar, Adrian Covic, Mehmet Kanbay
Anemia seen in patients with chronic kidney disease is a particular form of 'anemia of chronic disease'. Although multifactorial in origin, erythropoiesis-stimulating agents (ESAs) and adjuvant iron therapy represent the primary treatment for anemia in chronic kidney disease. Subsequent clinical observations revealed that these ESA hyporesponsive patients often had increased systemic inflammation as a consequence of their comorbidities. Use of high ESA doses to overcome this ESA hyporesponsiveness posed some concerns regarding associated adverse events of therapy and increased mortality in this special patient population...
2016: Blood Purification
https://www.readbyqxmd.com/read/27185524/iron-therapy-challenges-for-the-treatment-of-nondialysis-ckd-patients
#19
Francesco Locatelli, Sandro Mazzaferro, Jerry Yee
The clinical consequences of untreated, severe anemia in patients with nondialysis CKD can be significant, but disparities exist in the anemia treatment guidelines and position papers issued from working groups and associations across the world. These differ in hemoglobin target and iron levels and their emphasis on various iron markers and other clinical outcomes. Not surprisingly, disparities are observed in anemia treatment strategies among patients with nondialysis CKD across different areas of the world...
July 7, 2016: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/26848873/uremic-toxicity-induced-eryptosis-and-monocyte-modulation-the-erythrophagocytosis-as-a-novel-pathway-to-renal-anemia
#20
Natalia Borges Bonan, Thiago M Steiner, Viktoriya Kuntsevich, Grazia Maria Virzì, Marina Azevedo, Lia Sumie Nakao, Fellype Carvalho Barreto, Claudio Ronco, Stephan Thijssen, Peter Kotanko, Roberto Pecoits-Filho, Andréa N Moreno-Amaral
BACKGROUND: We tested the effect of uremia on red blood cell (RBC) eryptosis, CD14++/CD16+ monocytes and erythrophagocytosis. DESIGN: RBC and monocytes from chronic kidney disease (CKD) stages 3/4 (P-CKD3/4) or hemodialysis (HD) patients and healthy controls (HCs) cells incubated with sera pools from patients with CKD stages 2/3 (S-CKD2/3) or 4/5 (S-CKD4/5) were evaluated to assess eryptosis, monocyte phenotypes and reactive oxygen species (ROS) by cytometer. Erythrophagocytosis was evaluated by subsequent co-incubation of preincubated HC-monocytes and autologous-RBC...
2016: Blood Purification
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