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Renal Anemia

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159 papers 100 to 500 followers
By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
(no author information available yet)
No abstract text is available yet for this article.
December 1, 2018: Clinical and Experimental Nephrology
Kazuhiro Hara, Yasuhide Mizutani, Hitoshi Kodera, Masato Miyake, Yoshiki Yasuda, Sanae Ohara
INTRODUCTION: Several anemia guidelines for hemodialysis patients have recommended a target hemoglobin (Hb) range of 10-12 g/dL. However, maintaining Hb values continuously within a narrow target has been difficult, and there has been no generally accepted anemia management algorithm for hemodialysis patients. METHODS: In our study, we created an anemia management algorithm that considers the length of erythrocyte lifetimes, focuses on the combination of erythropoiesis-stimulating agent management and iron administration, and prevents iron deficiency and overload...
2015: International Journal of Nephrology and Renovascular Disease
Omar Maoujoud, Samir Ahid, Yahia Cherrah
OBJECTIVE: The purpose of this study was to determine the cost-utility of treating anemic dialysis patients with continuous erythropoietin receptor activator (CERA) once monthly or Epoetin Beta (EpoB) thrice weekly compared with a reference strategy of managing anemia with red blood cell transfusion (RBCT). METHODS: Cost-utility analysis study design. Decision analysis model, National health care payer, over 1 year with the publicly funded health care system. Chronic hemodialysis patients with renal anemia were included...
2016: International Journal of Nephrology and Renovascular Disease
Thierry Hannedouche, Denis Fouque, Dominique Joly
Metabolic complications of chronic kidney disease (CKD) are frequent; the aims of this review are to present a 2018 update for hyperkalemia, hyperphosphatemia and anemia. Hyperkalemia is defined by a plasma level above 5.0 mmol/L, after ruling out pre-analytical problems such as hemolysis. It is frequent in CKD, most often due to drugs and notably renin/ angiotensin blockers. Chronic hyperkalemia is deleterious, with an increased risk of mortality. Therapeutic strategies to decrease the incidence and severity of hyperkalemia are therefore crucial in nephrology: experts recommend to maintain the renin/angiotensin blockers as long as possible, whilst associating diuretics and potassium binders...
November 2018: Néphrologie & Thérapeutique
Mukul Jain, Amit Joharapurkar, Vishal Patel, Samadhan Kshirsagar, Brijesh Sutariya, Maulik Patel, Hiren Patel, Pankaj R Patel
Chronic inflammatory diseases are often associated with anemia. In such conditions, anemia is generally treated with erythropoiesis stimulating agents (ESAs) which are associated with potentially hazardous side effects and poor outcomes. Suboptimal erythropoiesis in chronic inflammation is believed to be caused by elevated hepcidin levels, which causes blockade of iron in tissue stores. In the current work using rodent models of inflammation, an orally available small molecule prolyl hydroxylase inhibitor desidustat was assessed as an effective treatment of anemia of inflammation...
November 17, 2018: European Journal of Pharmacology
Shinya Nakatani, Keiko Yasukawa, Eiji Ishimura, Ayumi Nakatani, Norikazu Toi, Hideki Uedono, Akihiro Tsuda, Shinsuke Yamada, Hitoshi Ikeda, Katsuhito Mori, Masanori Emoto, Yutaka Yatomi, Masaaki Inaba
Oxidative stress plays a major role in development of cardiovascular disease in patients with chronic kidney disease (CKD). Human mercaptalbumin (HMA), a reduced form of serum albumin, and non-mercaptalbumin (HNA), an oxidized form of serum albumin, are known as indicators for evaluating oxidative stress in systemic circulation, including end-stage renal disease cases. We investigated factors associated with fraction of HNA [f(HNA)] in 112 pre-dialysis CKD patients (63.6 ± 14.0 years old; 59 males, 53 females) using a newly established anion-exchange column packed with hydrophilic polyvinyl alcohol gel as well as high performance liquid chromatography...
November 14, 2018: Scientific Reports
Haesuk Park, Xinyue Liu, Linda Henry, Jeffrey Harman, Edward A Ross
BACKGROUND: The objective of the study was to examine overall anemia management trends in non-dialysis patients with chronic kidney disease (CKD) from 2006 to 2015, and to evaluate the impact of Trial to Reduced Cardiovascular Events with Ananesp Therapy (TREAT)'s study results (October 2009) and the US Food and Drug Administration (FDA)'s (June 2011) safety warnings and guidelines on the use of ESA therapy in the current treatment of anemia. METHODS: A retrospective cohort analysis of anemia management in CKD patients using Truven MarketScan Commercial and Medicare Supplemental databases was conducted...
November 9, 2018: BMC Nephrology
Guenter Weiss, Tomas Ganz, Lawrence T Goodnough
Anemia of inflammation (AI) also known as anemia of chronic disease (ACD) is regarded as the most frequent anemia in hospitalized and chronically ill patients. It is prevalent in patients with diseases that cause prolonged immune activation including infection, auto-immune diseases and cancer. More recently, the list has grown to include chronic kidney disease, congestive heart failure, chronic pulmonary diseases and obesity. Inflammation-inducible cytokines and the master regulator of iron homeostasis, hepcidin, block intestinal iron absorption and cause iron retention in reticuloendothelial cells resulting in iron-restricted erythropoiesis...
November 6, 2018: Blood
Peppi Koivunen, Thomas Kietzmann
Hypoxia-inducible factor prolyl 4-hydroxylases (HIF-P4Hs, also known as PHDs or EglNs) are enzymes that act as cellular oxygen sensors. Inhibition of HIF-P4Hs leads to stabilization of hypoxia-inducible transcription factors (HIFs), which initiates a gene expression program that allows organisms to cope with low oxygen levels and restore tissue oxygenation. This involves, for example, upregulation of erythropoiesis and angiogenesis, modulation of inflammatory responses, and reprogramming of metabolism. Currently, several pharmacological HIF-P4H inhibitors are in clinical trials mainly for renal anemia...
October 31, 2018: Trends in Molecular Medicine
Ko-Lin Kuo, Szu-Chun Hung, Wei-Cheng Tseng, Ming-Tsun Tsai, Jia-Sin Liu, Ming-Huang Lin, Chih-Cheng Hsu, Der-Cherng Tarng
Background The Taiwan Health Insurance Bureau has conducted a bundled payment system for hemodialysis reimbursement since 1995. The maximum dose of erythropoiesis-stimulating agents allowed by insurance is capped at 20 000 U of epoetin or 100 μg of darbepoetin alfa per month. Nephrologists have avoided the use of high dosages of erythropoiesis-stimulating agents to achieve a hemoglobin level of 10 to 11 g/dL by iron supplementation. The clinical impact of these policies on patients' outcomes is unknown...
August 7, 2018: Journal of the American Heart Association
Iain C Macdougall, Claire White, Stefan D Anker, Sunil Bhandari, Kenneth Farrington, Philip A Kalra, John J V McMurray, Heather Murray, Charles R V Tomson, David C Wheeler, Christopher G Winearls, Ian Ford
BACKGROUND: Intravenous iron is a standard treatment for patients undergoing hemodialysis, but comparative data regarding clinically effective regimens are limited. METHODS: In a multicenter, open-label trial with blinded end-point evaluation, we randomly assigned adults undergoing maintenance hemodialysis to receive either high-dose iron sucrose, administered intravenously in a proactive fashion (400 mg monthly, unless the ferritin concentration was >700 μg per liter or the transferrin saturation was ≥40%), or low-dose iron sucrose, administered intravenously in a reactive fashion (0 to 400 mg monthly, with a ferritin concentration of <200 μg per liter or a transferrin saturation of <20% being a trigger for iron administration)...
October 26, 2018: New England Journal of Medicine
Mark R Hanudel, Marciana Laster, Isidro B Salusky
PURPOSE OF REVIEW: We will review non-renal-related mechanisms of fibroblast growth factor 23 (FGF23) pathophysiology. RECENT FINDINGS: FGF23 production and metabolism may be affected by many bone, mineral, and kidney factors. However, it has recently been demonstrated that other factors, such as iron status, erythropoietin, and inflammation, also affect FGF23 production and metabolism. As these non-mineral factors are especially relevant in the setting of chronic kidney disease (CKD), they may represent emerging determinants of CKD-associated elevated FGF23 levels...
December 2018: Current Osteoporosis Reports
Tomas Ganz
Suzuki et al. analyzed a mouse model of erythropoietin-deficient anemia to show that during iron overload renal interstitial fibroblasts accumulate iron, and this impairs the hypoxia-driven transcription of the erythropoietin gene. The authors show that excess iron decreases levels of hypoxia-inducible transcription factor 2α (HIF2α), the main driver of erythropoietin production in hypoxia and anemia. The work advances our understanding of the effect of iron on hypoxia signaling, but its implications for anemia treatment are less clear...
November 2018: Kidney International
Mayra Vera-Aviles, Eleni Vantana, Emmy Kardinasari, Ngat L Koh, Gladys O Latunde-Dada
Anemia is a major health condition associated with chronic kidney disease (CKD). A key underlying cause of this disorder is iron deficiency. Although intravenous iron treatment can be beneficial in correcting CKD-associated anemia, surplus iron can be detrimental and cause complications. Excessive generation of reactive oxygen species (ROS), particularly by mitochondria, leads to tissue oxidation and damage to DNA, proteins, and lipids. Oxidative stress increase in CKD has been further implicated in the pathogenesis of vascular calcification...
October 21, 2018: Pharmaceuticals
Andy K H Lim, Arushi Kansal, John Kanellis
BACKGROUND: Anaemia after kidney transplantation may reduce quality of life, graft or patient survival. We aimed to determine the prevalence and risk factors for anaemia in the initial 12 months after transplantation. METHODS: We conducted a cross-sectional study at 6 and 12 months after transplantation. Anaemia was defined by World Health Organization criteria taking into consideration erythropoietin use. Logistic regression was used to determine the association between demographic, clinical and pharmacological risk factors for the main outcome of moderate-severe anaemia...
October 5, 2018: BMC Nephrology
Hongzhen Zhong, Tianbiao Zhou, Hongyan Li, Zhiqing Zhong
Introduction: The purpose of this study was to analyze the effects of hypoxia-inducible factor (HIF) stabilizers on anemia in non-dialysis-dependent (NDD) and dialysis-dependent (DD) chronic kidney disease (CKD) patients. Methods: Published studies were extracted from PubMed, China Biological Medicine Database (CBM), Wanfang database, and Cochrane Library on March 10, 2018, and relevant studies were pooled and included in a meta-analysis. Data on hemoglobin (Hb), ferritin, and hepcidin levels, total iron-binding capacity (TIBC), and incidence of adverse events (AEs) were extracted and pooled using Review Manager Version 5...
2018: Drug Design, Development and Therapy
James B Wetmore, Suying Li, Heng Yan, Hairong Xu, Yi Peng, Marvin V Sinsakul, Jiannong Liu, David T Gilbertson
Whether and how anemia treatment with erythropoiesis stimulating agents (ESAs) before hemodialysis initiation may be associated with lower mortality after dialysis initiation is unknown. We compared all-cause and cardiovascular mortality in two groups of patients who experienced distinct anemia treatment patterns with ESAs before and after hemodialysis initiation. This retrospective cohort analysis included patients initiating hemodialysis April 1, 2012-June 30, 2013, identified from United States Renal Data System end-stage renal disease (ESRD) and pre-ESRD files...
2018: PloS One
J Brian Lanier, James J Park, Robert C Callahan
Anemia is associated with increased morbidity and mortality in older adults. Diagnostic cutoff values for defining anemia vary with age, sex, and possibly race. Anemia is often asymptomatic and discovered incidentally on laboratory testing. Patients may present with symptoms related to associated conditions, such as blood loss, or related to decreased oxygen-carrying capacity, such as weakness, fatigue, and shortness of breath. Causes of anemia in older adults include nutritional deficiency, chronic kidney disease, chronic inflammation, and occult blood loss from gastrointestinal malignancy, although in many patients the etiology is unknown...
October 1, 2018: American Family Physician
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
2018-09-22 08:39:29
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