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CKD Anemia

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22 papers 0 to 25 followers
By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
https://www.readbyqxmd.com/read/27760419/relationship-between-anemia-and-serum-concentrations-of-calcium-and-phosphorus-in-advanced-non-dialysis-dependent-chronic-kidney-disease
#1
Mauro Boronat, Ángelo Santana, Elvira Bosch, Dionisio Lorenzo, Marta Riaño, César García-Cantón
BACKGROUND/AIMS: Different biochemical abnormalities of metabolic bone disease have been associated with anemia of chronic kidney disease (CKD), mainly in hemodialysis patients. However, all of these abnormalities are closely inter-related and their individual effect on the development of anemia is uncertain. This study was aimed to assess the relationship between anemia and a set of metabolic bone disease biomarkers in a cohort of adult patients with advanced non-dialysis-dependent CKD...
October 20, 2016: Nephron
https://www.readbyqxmd.com/read/27699922/intravenous-iron-and-erythropoiesis-stimulating-agents-in-haemodialysis-a-systematic-review-and-meta-analysis
#2
S D Roger, M Tio, H C Park, H L Choong, B Goh, T R Cushway, V Stevens, I C Macdougall
AIM: Higher dosages of erythropoiesis-stimulating agents (ESAs) have been associated with adverse effects. Intravenous iron is used to optimise ESA response and reduce ESA doses in haemodialysis patients; this meta-analysis evaluates the magnitude of this effect. METHODS: A literature search was performed using MEDLINE, Embase and the Cochrane Collaboration Central Register of Clinical Trials from inception until December 2014, to identify randomised controlled trials (RCTs) of intravenous iron and ESA, in patients undergoing haemodialysis for end-stage kidney disease...
October 3, 2016: Nephrology
https://www.readbyqxmd.com/read/27650732/vadadustat-a-novel-oral-hif-stabilizer-provides-effective-anemia-treatment-in-nondialysis-dependent-chronic-kidney-disease
#3
Pablo E Pergola, Bruce S Spinowitz, Charlotte S Hartman, Bradley J Maroni, Volker H Haase
Current treatment of anemia in chronic kidney disease (CKD) with erythropoiesis-stimulating agents can lead to substantial hemoglobin oscillations above target range and high levels of circulating erythropoietin. Vadadustat (AKB-6548), a novel, titratable, oral hypoxia-inducible factor prolyl hydroxylase inhibitor induces endogenous erythropoietin synthesis and enhances iron mobilization. In this 20-week, double-blind, randomized, placebo-controlled, phase 2b study, we evaluated the efficacy and safety of once-daily vadadustat in patients with stages 3a to 5 non-dialysis-dependent CKD...
November 2016: Kidney International
https://www.readbyqxmd.com/read/27604984/intravenous-iron-administration-strategies-and-anemia-management-in-hemodialysis-patients
#4
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...
September 6, 2016: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/27458564/diabetes-mellitus-increases-the-prevalence-of-anemia-in-patients-with-chronic-kidney-disease-a-nested-case-control-study
#5
Charalampos Loutradis, Alexandra Skodra, Panagiotis Georgianos, Panagiota Tolika, Dimitris Alexandrou, Afroditi Avdelidou, Pantelis A Sarafidis
AIM: To compare anemia prevalence between matched chronic kidney disease (CKD) patients with and without diabetes mellitus (DM) and to assess factors associated with anemia development. METHODS: This is a nested case-control study of 184 type-2 diabetic and 184 non-diabetic CKD patients from a prospectively assembled database of a Nephrology outpatient clinic, matched for gender, age and estimated glomerular filtration rate (eGFR). Prevalence of anemia (hemoglobin: Men: < 13 g/dL, women: < 12 g/dL and/or use of recombinant erythropoietin) was examined in comparison, in the total population and by CKD Stage...
July 6, 2016: World Journal of Nephrology
https://www.readbyqxmd.com/read/27318465/novel-masters-of-erythropoiesis-hypoxia-inducible-factors-and-recent-advances-in-anemia-of-renal-disease
#6
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/26881842/the-effect-of-erythropoietin-stimulating-agents-on-health-related-quality-of-life-in-anemia-of-chronic-kidney-disease-a-systematic-review-and-meta-analysis
#7
REVIEW
David Collister, Paul Komenda, Brett Hiebert, Ravindi Gunasekara, Yang Xu, Fredrick Eng, Blake Lerner, Kerry Macdonald, Claudio Rigatto, Navdeep Tangri
BACKGROUND: The efficacy of erythropoietin-stimulating agents (ESAs) for improving health-related quality of life (HRQOL) in anemia of chronic kidney disease (CKD) is unclear. PURPOSE: To determine the effect of ESAs on HRQOL at different hemoglobin targets in adults with CKD who were receiving or not receiving dialysis. DATA SOURCES: Searches of PubMed, EMBASE, the Cochrane Library, and ClinicalTrials.gov from inception to 1 November 2015, supplemented with manual screening...
April 5, 2016: Annals of Internal Medicine
https://www.readbyqxmd.com/read/27083270/higher-hemoglobin-levels-and-quality-of-life-in-patients-with-advanced-chronic-kidney-disease-no-longer-a-moving-target
#8
COMMENT
Christina M Wyatt, Tilman B Drueke
International clinical practice guidelines for the management of anemia in chronic kidney disease suggest target hemoglobin levels ≤ 11.5 g/dl (115 g/l), with individualized consideration of slightly higher hemoglobin targets to improve quality of life. An updated meta-analysis of randomized trials demonstrates no significant improvement in quality of life with erythropoietin-stimulating agent therapy targeting higher hemoglobin levels. Limitations of the available data suggest that individualized targets should nonetheless remain an option in future clinical practice guidelines...
May 2016: Kidney International
https://www.readbyqxmd.com/read/26894799/the-safety-of-erythropoiesis-stimulating-agents-for-the-treatment-of-anemia-resulting-from-chronic-kidney-disease
#9
REVIEW
Nicolas Roberto Robles
Chronic kidney disease (CKD) anemia treatment was revolutionized in the late 1980s with the introduction of recombinant human erythropoietin. This and related erythropoiesis-stimulating agents (ESAs) greatly benefited patients by decreasing debilitating symptoms, improving their quality of life, and freeing them from dependence on blood transfusions with their associated complications such as infections, sensitization impeding transplantation, and secondary iron overload. However, even in the initial studies, untoward effects were noted in patients receiving ESAs, including worsening hypertension, seizures, and dialysis access clotting...
June 2016: Clinical Drug Investigation
https://www.readbyqxmd.com/read/26790135/recombinant-human-erythropoietin-versus-placebo-or-no-treatment-for-the-anaemia-of-chronic-kidney-disease-in-people-not-requiring-dialysis
#10
REVIEW
June D Cody, Elisabeth M Hodson
BACKGROUND: Treatment with recombinant human erythropoietin (rHuEPO) in dialysis patients has been shown to be highly effective in terms of correcting anaemia and improving quality of life. There is debate concerning the benefits of rHuEPO use in predialysis patients which may accelerate the deterioration of kidney function. However the opposing view is that if rHuEPO is as effective in predialysis patients, improving the patient's sense of well-being may result in the onset of dialysis being delayed...
2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/26779906/a-prospective-observational-study-of-early-intervention-with-erythropoietin-therapy-and-renal-survival-in-non-dialysis-chronic-kidney-disease-patients-with-anemia-jet-stream-study
#11
Tadao Akizawa, Yoshiharu Tsubakihara, Hideki Hirakata, Yuzo Watanabe, Hiroki Hase, Shinichi Nishi, Tetsuya Babazono, Michiko Kumagai, Shingo Katakura, Yukari Uemura, Yasuo Ohashi
BACKGROUND: There is limited data showing that early treatment for anemia could prolong renal survival in non-dialysis chronic kidney disease (CKD) patients. We therefore investigated the relationship between hemoglobin (Hb) levels at initiation of epoetin beta therapy and renal outcome in non-dialysis CKD patients with anemia. METHODS: In this prospective, multi-center, observational study, non-dialysis CKD patients with anemia who were naïve to erythropoiesis-stimulating agents (ESAs) were divided into three groups based on their Hb levels at initiation of epoetin beta therapy (Group I: 10 ≤ Hb < 11 g/dL, Group II: 9 ≤ Hb < 10 g/dL, and Group III: Hb < 9 g/dL)...
December 2016: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/26759045/iron-management-in-chronic-kidney-disease-conclusions-from-a-kidney-disease-improving-global-outcomes-kdigo-controversies-conference
#12
Iain C Macdougall, Andreas J Bircher, Kai-Uwe Eckardt, Gregorio T Obrador, Carol A Pollock, Peter Stenvinkel, Dorine W Swinkels, Christoph Wanner, Günter Weiss, Glenn M Chertow
Before the introduction of erythropoiesis-stimulating agents (ESAs) in 1989, repeated transfusions given to patients with end-stage renal disease caused iron overload, and the need for supplemental iron was rare. However, with the widespread introduction of ESAs, it was recognized that supplemental iron was necessary to optimize hemoglobin response and allow reduction of the ESA dose for economic reasons and recent concerns about ESA safety. Iron supplementation was also found to be more efficacious via intravenous compared to oral administration, and the use of intravenous iron has escalated in recent years...
January 2016: Kidney International
https://www.readbyqxmd.com/read/26763385/diagnosis-and-management-of-iron-deficiency-in-ckd-a-summary-of-the-nice-guideline-recommendations-and-their-rationale
#13
Laura E K Ratcliffe, Wayne Thomas, Jessica Glen, Smita Padhi, Ben A J Pordes, David Wonderling, Roy Connell, Suzanne Stephens, Ashraf I Mikhail, Damian G Fogarty, Jan K Cooper, Belinda Dring, Mark A J Devonald, Chris Brown, Mark E Thomas
The UK-based National Institute for Health and Care Excellence (NICE) has updated its guidance on iron deficiency and anemia management in chronic kidney disease. This report outlines the recommendations regarding iron deficiency and their rationale. Serum ferritin alone or transferrin saturation alone are no longer recommended as diagnostic tests to assess iron deficiency. Red blood cell markers (percentage hypochromic red blood cells, reticulocyte hemoglobin content, or reticulocyte hemoglobin equivalent) are better than ferritin level alone at predicting responsiveness to intravenous iron...
April 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/26757994/increased-synthesis-of-liver-erythropoietin-with-ckd
#14
Sophie de Seigneux, Anne-Kristine Meinild Lundby, Lena Berchtold, Anders H Berg, Patrick Saudan, Carsten Lundby
Anemia of CKD seems to be related to impaired production of renal erythropoietin (Epo). The glycosylation pattern of Epo depends on the synthesizing cell and thus, can indicate its origin. We hypothesized that synthesis of Epo from nonkidney cells increases to compensate for insufficient renal Epo production during CKD. We determined plasma Epo levels and Epo glycosylation patterns in 33 patients with CKD before undergoing dialysis and nine patients with CKD undergoing dialysis. We compared these values with values obtained in healthy volunteers and other controls...
August 2016: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/26622355/hemoglobin-discriminates-stages-of-chronic-kidney-disease-in-elderly-patients
#15
Ying Chen, Mingzhao Qin, Jie Zheng, Hong Yan, Mei Li, Yao Cui, Ruihua Zhang, Wei Zhao, Ying Guo
The prevalence of chronic kidney disease (CKD) increases with age, and anemia is known to affect the outcome of subjects with CKD. However, little is known with regard to the associations between metabolic complications and stages of CKD among elderly patients. Thus, the aim of the present study was to investigate the prevalence of CKD in elderly Chinese patients, as well as the associations between stages of CKD and clinically important complications of anemia. In total, 2,258 individuals with CKD, divided into younger (n=989) and elderly (n=1,269) groups, were enrolled in the study between June 2009 and December 2011...
August 2015: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/26422625/oral-or-intravenous-iron-for-anemia-correction-in-chronic-kidney-disease
#16
COMMENT
Tilman B Drüeke, Ziad A Massy
Iron deficiency in patients with chronic kidney disease (CKD) can be corrected by the oral or intravenous route. The natural intestinal barrier against iron overload is circumvented by intravenous iron. The balance between benefit and risk of high iron doses remains unclear. In a randomized controlled trial in CKD patients, Agarwal et al. find similar effects of oral and intravenous iron on hemoglobin levels and kidney function decline but more serious cardiovascular events and infections with intravenous iron...
October 2015: Kidney International
https://www.readbyqxmd.com/read/26398496/inducible-glomerular-erythropoietin-production-in-the-adult-kidney
#17
Katharina Gerl, Lucile Miquerol, Vladimir T Todorov, Christian P M Hugo, Ralf H Adams, Armin Kurtz, Birgül Kurt
Hypoxia-inducible factor (HIF)-2-triggered erythropoietin production in renal interstitial fibroblast-like cells is the physiologically relevant source of erythropoietin for regulating erythropoiesis. During renal fibrosis, these cells transform into myofibroblasts and lose their ability to produce sufficient erythropoietin leading to anemia. To find if other cells for erythropoietin production might exist in the kidney we tested for the capability of nonepithelial glomerular cells to elaborate erythropoietin...
September 23, 2015: Kidney International
https://www.readbyqxmd.com/read/26381503/how-the-target-hemoglobin-of-renal-anemia-should-be
#18
REVIEW
Imari Mimura, Tetsuhiro Tanaka, Masaomi Nangaku
Renal anemia is caused by the deficiency of endogenous erythropoietin (Epo) due to renal dysfunction. We think that it is possible to slow the progression of chronic kidney disease (CKD) in case we initiate Epo early in pre-dialysis patients, especially in the non-diabetic population. Erythropoiesis stimulating agent (ESA) treatments targeting mild anemia (10-12 g/dl) can decrease the risk of occurrence of cardiovascular disease (CVD) in patients with hypertension, diabetes mellitus and congestive heart failure...
2015: Nephron
https://www.readbyqxmd.com/read/26381391/how-to-supplement-iron-in-patients-with-renal-anemia
#19
REVIEW
Shinji Tanaka, Tetsuhiro Tanaka
Iron deficiency is a major cause of hyporesponsiveness to erythropoiesis-stimulating agents (ESAs) and is often observed in chronic kidney disease (CKD) patients with anemia. With iron supplementation, ESA doses can be decreased, resulting in lower treatment costs and possibly lower cardiovascular risks that are associated with high-dose ESA therapy. The 2012 Kidney Disease: Improving Global Outcomes Guideline specified ferritin ≤ 500 ng/ml and transferrin saturation (TSAT) ≤ 30% as thresholds of iron parameters for CKD patients...
2015: Nephron
https://www.readbyqxmd.com/read/26372086/new-treatment-approaches-for-the-anemia-of-ckd
#20
REVIEW
Mario Bonomini, Lucia Del Vecchio, Vittorio Sirolli, Francesco Locatelli
Normocytic normochromic anemia is a common complication in chronic kidney disease and is associated with many adverse clinical consequences. Erythropoiesis-stimulating agents (ESAs) and adjuvant iron therapy represent the primary treatment for anemia in chronic kidney disease. The introduction of ESAs into clinical practice was a success story, mediating an increase in hemoglobin concentrations without the risk for recurrent blood transfusions and improving quality of life substantially. However, recombinant ESAs are still expensive and require a parenteral route of administration...
January 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
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