Anemia in renal disease: Diagnosis and management

Lankhorst, Christina E.; Wish, Jay B.

doi:10.1016/j.blre.2009.09.001

Cited by 109 publications

(99 citation statements)

References 65 publications

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“…The pathogenesis is multifactorial [1], but a deficiency of erythropoietin (Epo) due to kidney injury is thought to play a major role, concomitant with reduced red blood cells life span, bleeding diathesis due to platelet dysfunction, and deficiency of iron, folate, and cobalamin. However, the persistence of anemia despite Epo, iron and vitamin supplementation suggests a concomitant bone marrow hypo-responsiveness in these patients.…”

Section: Anemia and Iron Status In Chronic Hemodialysis Patientsmentioning

confidence: 99%

Hepcidin levels in chronic hemodialysis patients: a critical evaluation

Valenti

Pelusi

Campostrini

et al. 2014

Clinical Chemistry and Laboratory Medicine

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Altered systemic iron metabolism is a key element of uremia, and functional iron deficiency mainly related to subclinical inflammation makes it difficult to maintain proper control of anemia in chronic hemodialysis patients (CHD). In the last decade, the hepatic hormone hepcidin has been progressively recognized as the master regulator of circulating iron levels through the modulation of cellular iron fluxes in response to iron stores, as well as to erythroid and inflammatory stimuli. Hepcidin is cleared by the kidney and progression of renal disease has been associated to increased serum hepcidin levels. This, in turn, reduces iron availability for erythropoiesis, suggesting anti-hepcidin strategies for improving anemia control. Moreover, hepcidin has been recently implicated in the pathogenesis of long-term complications of dialysis, like accelerated atherosclerosis. Initial studies almost invariably reported a sustained increase of serum hepcidin in chronic hemodialysis patients. Noteworthy, such studies included relatively few patients and controls that were poorly matched for major determinants of serum hepcidin at population level, i.e., age and gender. More recent data based on accurately matched larger series challenge the view that hepcidin is intrinsically increased in hemodialysis patients, showing a marked inter-and intra-individual variability of hormone levels. Here we take a critical look to the data published so far on hepcidin levels in CHD, analyze the reasons underlying the discrepancies in available studies and the hepcidin variability in CHD, and point out the need for further studies in large series of well-characterized CHD patients and controls.

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Section: Anemia and Iron Status In Chronic Hemodialysis Patientsmentioning

confidence: 99%

Hepcidin levels in chronic hemodialysis patients: a critical evaluation

Valenti

Pelusi

Campostrini

et al. 2014

Clinical Chemistry and Laboratory Medicine

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“…The cause of anemia in patients with chronic kidney disease is multifactorial (Lankhorst and Wish 2010), but it is believed that a deficit of erythropoietin (Epo) due to kidney injury plays a major role. Indeed, it is generally advised that erythropoiesis-stimulating agent (ESAs) should be given to all patients with ESRD with hemoglobin (Hb) levels consistently (i.e.…”

Section: Anemia In Esrdmentioning

confidence: 99%

“…As a result, FDA has issued a ''black box" warning, recommending that patients undergo a 25 mg test dose the first time the drug is given. If a patient does not have an adverse reaction to this dose, he/she is less likely to have an anaphylactic reaction to the therapeutic dose of iron dextran, but fatal anaphylactic reactions still occur with an uneventful test dose (Lankhorst and Wish 2010).…”

Section: Wwwintechopencommentioning

confidence: 99%

Modulation of Iron Metabolism and Hepcidin Release by HFE Mutations in Chronic Hemodialysis Patients: Pathophysiological and Therapeutic Implications

Canavesi¹,

Valenti²

2011

Hemodialysis - Different Aspects

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“…19 One of the rare but clinical relevant complications associated with ESAs is development of pure red blood cell aplasia due to anti-erythropoietin antibodies against exogenously administrated ESAs. 15 There is a theoretical concern regarding development of antibodies against darbepoetin leading to loss of its effectiveness; however, long term experience shows no antibodies have been reported against it, possibly because of its protective structural nature.…”

Section: Safety Of Darbepoetinmentioning

confidence: 99%

“…15 These agents cause increase in the level of hemoglobin in patients with anemia in CKD and reduce requirement for blood transfusion. In CKD patients, administration of these agents helps to improve the survival.…”

Section: Introductionmentioning

confidence: 99%

Darbepoetin alfa: review in the management of anemia in patients with chronic kidney disease

Barkate

Kothari

Patel

et al. 2017

Int J Basic Clin Pharmacol

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Chronic kidney disease (CKD) is a significant clinical problem across the world including India. The SEEK (Screening and Early Evaluation of Kidney Disease) study from India reported the prevalence of CKD as 17.2%. Diabetic nephropathy, undetermined etiology, chronic glomerulonephritis and hypertensive nephrosclerosis are the common causes of CKD in India. Rising rates of diabetes and hypertension, late presentation of patients to nephrologists and limited number of nephrologists in India adds to the concerns related to management of CKD. Considering the pathophysiology of CKD, anemia is almost an inevitable complication in these patients. Untreated anemia significantly contributes to the morbidity and mortality associated with CKD. Early recognition, timely management with appropriate therapy helps to reduce the complications of anemia. Erythropoiesis-stimulating agents (ESAs) are one of the important measures for correction of anemia in CKD patients. Darbepoetin, an ESA is a valuable therapeutic option for the treatment of anemia in CKD patients and has played a vital role in enhancing anemia management. In this article we reviewed the efficacy and safety data along with key benefits and place of darbepoetin alfa in the management of anemia in CKD patients.

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Anemia in renal disease: Diagnosis and management

Cited by 109 publications

References 65 publications

Hepcidin levels in chronic hemodialysis patients: a critical evaluation

Hepcidin levels in chronic hemodialysis patients: a critical evaluation

Modulation of Iron Metabolism and Hepcidin Release by HFE Mutations in Chronic Hemodialysis Patients: Pathophysiological and Therapeutic Implications

Darbepoetin alfa: review in the management of anemia in patients with chronic kidney disease

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