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By Erica Yama Nephrologist
Valeria M Saglimbene, Suetonia C Palmer, Marinella Ruospo, Patrizia Natale, Jonathan C Craig, Giovanni Fm Strippoli
BACKGROUND: Continuous erythropoiesis receptor activator (CERA) is a newer, longer acting ESA which might be preferred to other ESAs (epoetin or darbepoetin) based on its lower frequency of administration. Different dosing requirements and molecular characteristics of CERA compared with other ESAs may lead to different health outcomes (mortality, cardiovascular events, quality of life) in people with anaemia and chronic kidney disease (CKD). OBJECTIVES: To assess benefits and harms of CERA compared with other epoetins (darbepoetin alfa and epoetin alfa or beta) or placebo/no treatment or CERA with differing strategy of administration for anaemia in individuals with CKD...
August 7, 2017: Cochrane Database of Systematic Reviews
Anthony Lopez, Patrice Cacoub, Iain C Macdougall, Laurent Peyrin-Biroulet
Anaemia affects roughly a third of the world's population; half the cases are due to iron deficiency. It is a major and global public health problem that affects maternal and child mortality, physical performance, and referral to health-care professionals. Children aged 0-5 years, women of childbearing age, and pregnant women are particularly at risk. Several chronic diseases are frequently associated with iron deficiency anaemia--notably chronic kidney disease, chronic heart failure, cancer, and inflammatory bowel disease...
February 27, 2016: Lancet
Sandra Ribeiro, Luís Belo, Flávio Reis, Alice Santos-Silva
Anemia is a common complication in patients with chronic kidney disease (CKD), mainly due to inadequate renal production of erythropoietin. In hemodialysis (HD) patients this condition may be aggravated by iron deficiency (absolute or functional). The correction of this anemia is usually achieved by treatment with erythropoiesis stimulating agents (ESAs) and iron (oral or intravenous). Studies questioning the safety of ESAs (especially at higher doses) changed the pattern of anemia treatment in CKD patients...
January 2016: Blood Reviews
Deirdre Hahn, June D Cody, Elisabeth M Hodson
BACKGROUND: The benefits of erythropoiesis-stimulating agents (ESA) for dialysis patients have been demonstrated. However, it remains unclear whether the efficacy and safety of new, longer-acting ESA given less frequently is equivalent to recombinant human erythropoietin (rHuEPO) preparations. This is an update of a review first published in 2002 and last updated in 2005. OBJECTIVES: This review aimed to establish the optimal frequency of ESA administration in terms of effectiveness (correction of anaemia, and freedom from adverse events) and efficiency (optimal resource use) of different ESA dose regimens...
May 28, 2014: Cochrane Database of Systematic Reviews
Navdeep Tangri, Dana C Miskulin, Jing Zhou, Karen Bandeen-Roche, Wieneke M Michels, Patti L Ephraim, Aidan McDermott, Deidra C Crews, Julia J Scialla, Stephen M Sozio, Tariq Shafi, Bernard G Jaar, Klemens Meyer, L Ebony Boulware
BACKGROUND: Intravenous iron use in hemodialysis patients has greatly increased over the last decade, despite limited studies on the safety of iron. METHODS: We studied the association of receipt of intravenous iron with hospitalizations in an incident cohort of hemodialysis patients. We examined 9544 patients from Dialysis Clinic, Inc. (DCI). We ascertained intravenous iron use from DCI electronic medical record and USRDS data files, and hospitalizations through Medicare claims...
April 2015: Nephrology, Dialysis, Transplantation
James S Kaufman
No abstract text is available yet for this article.
February 2013: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Jeffrey S Berns
No abstract text is available yet for this article.
October 2014: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Jodie L Babitt, Herbert Y Lin
Anemia is a common feature of CKD associated with poor outcomes. The current management of patients with anemia in CKD is controversial, with recent clinical trials demonstrating increased morbidity and mortality related to erythropoiesis stimulating agents. Here, we examine recent insights into the molecular mechanisms underlying anemia of CKD. These insights hold promise for the development of new diagnostic tests and therapies that directly target the pathophysiologic processes underlying this form of anemia...
October 2012: Journal of the American Society of Nephrology: JASN
Norio Hanafusa, Takanobu Nomura, Takeshi Hasegawa, Masaomi Nangaku
BACKGROUND: The elderly hemodialyzed population is growing. However, little is known about the relationship between hemoglobin level and survival according to age. We investigated the effect of age on the relationship between hemoglobin and survival within the Japan Dialysis Outcomes and Practice Patterns Study (DOPPS) cohort. METHODS: We enrolled the entire Japan DOPPS phases 3 and 4 population. Patients were divided by the age of 75 years into two groups. Cox's proportional hazard model was used with hemoglobin at every 4 months treated as a time-dependent variable...
December 2014: Nephrology, Dialysis, Transplantation
Devan Kansagara, Edward Dyer, Honora Englander, Rongwei Fu, Michele Freeman, David Kagen
BACKGROUND: The benefits of anemia treatment in patients with heart disease are uncertain. PURPOSE: To evaluate the benefits and harms of treatments for anemia in adults with heart disease. DATA SOURCES: MEDLINE, EMBASE, and Cochrane databases; clinical trial registries; reference lists; and technical advisors. STUDY SELECTION: English-language trials of blood transfusions, iron, or erythropoiesis-stimulating agents in adults with anemia and congestive heart failure or coronary heart disease and observational studies of transfusion...
December 3, 2013: Annals of Internal Medicine
Jula K Inrig, Huiman X Barnhart, Donal Reddan, Uptal D Patel, Shelly Sapp, Robert M Califf, Ajay K Singh, Lynda A Szczech
BACKGROUND: Conflicting relationships have been described between anemia correction using erythropoiesis-stimulating agents and progression of chronic kidney disease (CKD). This study was undertaken to examine the impact of target hemoglobin level on progression of kidney disease in the CHOIR (Correction of Hemoglobin and Outcomes in Renal Insufficiency) trial. STUDY DESIGN: Secondary analysis of a randomized controlled trial. SETTING & PARTICIPANTS: 1,432 participants with CKD and anemia...
September 2012: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Anne M S Belonje, Adriaan A Voors, Peter van der Meer, Wiek H van Gilst, Tiny Jaarsma, Dirk J van Veldhuisen
BACKGROUND: Endogenous erythropoietin is increased in patients with heart failure (HF). Previous small-scale data suggest that these erythropoietin levels are related to prognosis. This study aims to analyze the clinical and prognostic value of erythropoietin levels in relation to hemoglobin in a large cohort of HF patients. METHODS AND RESULTS: In patients hospitalized for HF, endogenous erythropoietin levels were measured at discharge and after 6 months. In anemic patients, the relation between erythropoietin and hemoglobin levels was determined by calculating the observed/predicted ratio of erythropoietin levels...
January 19, 2010: Circulation
Tomer Avni, Leonard Leibovici, Anat Gafter-Gvili
AIMS: Over half of chronic heart failure (CHF) patients are anaemic, and iron deficiency is common. Iron replacement therapy (oral or i.v.) might improve exercise capacity and quality of life (QOL). METHODS AND RESULTS: We carried out a systematic review and meta-analysis of all randomized control trials that compared iron with no therapy for CHF patients with iron deficiency, whether or not they were anaemic. We searched electronic databases as well as haematology and cardiology conferences up to August 2011...
April 2012: European Journal of Heart Failure
Marco Metra, Adriaan A Voors
Heart failure and kidney disease often coexist, and each of the two conditions may lead to progression of the other. Kidney dysfunction is an independent prognostic factor in patients with either acute or chronic heart failure. Worsening renal function may be related with poorer outcomes as well. Multiple mechanisms are involved in the cardio-renal interaction, including hemodynamic abnormalities, neurohormonal and inflammatory activation, oxidative stress, anemia, and abnormalities in mineral and vitamin D metabolism...
March 2012: Heart Failure Reviews
I H Kraai, M L A Luttik, P Johansson, R M De Jong, D J Van Veldhuisen, H L Hillege, T Jaarsma
BACKGROUND: Anemia is a serious and highly prevalent co-morbidity in chronic heart failure (HF) patients. Its influence on health-related quality of life (HR-QoL) has rarely been studied, and no data is available regarding the role it plays in hospitalized HF patients. METHODS: Baseline data from the COACH study (Coordinating study evaluating Outcomes of Advising and Counselling in Heart Failure) were used. HR-QoL was assessed by means of generic and disease-specific questionnaires...
November 29, 2012: International Journal of Cardiology
Amir Qaseem, Linda L Humphrey, Nick Fitterman, Melissa Starkey, Paul Shekelle
DESCRIPTION: The American College of Physicians (ACP) developed this guideline to present the evidence and provide clinical recommendations on the treatment of anemia and iron deficiency in adult patients with heart disease. METHODS: This guideline is based on published literature in the English language on anemia and iron deficiency from 1947 to July 2012 that was identified using MEDLINE and the Cochrane Library. Literature was reassessed in April 2013, and additional studies were included...
December 3, 2013: Annals of Internal Medicine
W H Wilson Tang
Anemia is commonly observed in patients with heart failure, and portends worsening functional capacity and poorer long-term prognosis. Nevertheless, uncertainty remains regarding the underlying pathophysiology and natural history of anemia in the setting of chronic heart failure. The optimal therapeutic targets and treatment options for this "anemia of heart failure" are also uncertain. Careful evaluation of potential underlying reversible causes, particularly renal insufficiency and iron or nutritional deficiencies, may lead to potential treatment options...
2007: Reviews in Cardiovascular Medicine
Luís Beck-da-Silva, Diogo Piardi, Stephan Soder, Luís Eduardo Rohde, Antônio Carlos Pereira-Barretto, Denílson de Albuquerque, Edimar Bocchi, Fábio Vilas-Boas, Lídia Zytynzki Moura, Marcelo W Montera, Salvador Rassi, Nadine Clausell
BACKGROUND: Anemia in heart failure patients and has been associated with increased morbi-mortality. Previous studies have treated anemia in heart failure patients with either erythropoietin alone or combination of erythropoietin and intravenous (i.v.) iron. However, the effect of i.v. or oral (p.o.) iron supplementation alone in heart failure patients with anemia was virtually unknown. AIM: To compare, in a double-blind design, the effects of i.v. iron versus p...
October 9, 2013: International Journal of Cardiology
Hasan Mahmud, Willem P T Ruifrok, B Daan Westenbrink, Megan V Cannon, Inge Vreeswijk-Baudoin, Wiek H van Gilst, Herman H W Silljé, Rudolf A de Boer
AIMS: Suicidal death of erythrocytes (eryptosis) is characterized by cell shrinkage and exposure of phosphatidylserine (PS) residues at the cell surface. Excessive eryptosis may lead to anaemia. We aimed to study the role of eryptosis in heart failure (HF)-associated anaemia. METHODS AND RESULTS: We measured eryptosis in rodent models of HF. Typical measures of eryptosis including PS-exposure, increased intracellular Ca(2+) levels, and decreased cell volume were determined by flow cytometry...
April 1, 2013: Cardiovascular Research
2014-08-26 02:14:38
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