Impact of correction of anemia in end-stage renal disease patients on cerebral circulation and cognitive functions

Shaker, Amr; Mohamed, Omar Ahmed; Mohamed, Moataz F.; El-Khashaba, Sahier Omar

doi:10.4103/1319-2442.248306

Cited by 13 publications

(18 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Besides, some experimental and clinical studies have shown that through inhibiting the renin-angiotensin system in patients with dementia, not only is the progression of renal disease slowed down, but dementia incident risks can also be reduced [ 54 , 55 ]. Moreover, restoration of malnutrition and anemia has also been reported to improve cognition in older patients with dementia [ 56 , 57 ]. In caring for elderly patients with dementia, clinicians should not only recognize the severity of cognitive dysfunction, but should also examine the nutrition and hemoglobin before proposing treatment strategies to slow progression of cognition impairment.…”

Section: Discussionmentioning

confidence: 99%

Effects of kidney function, serum albumin and hemoglobin on dementia severity in the oldest old people with newly diagnosed Alzheimer’s disease in a residential aged care facility: a cross-sectional study

Weng

Liang

et al. 2020

BMC Geriatr

View full text Add to dashboard Cite

Background Chronic kidney disease (CKD), low serum albumin, and anemia are known risk factors for cognitive decline in older people. We investigated the association between kidney function and cognitive impairment severity in oldest-old people with a diagnosis of Alzheimer’s disease (AD). Methods A cross-sectional study of patients aged 80 years and older was conducted at a veterans’ home in Taiwan between 2012 and 2016. Their estimated glomerular filtration rate (eGFR) was determined using the Modification of Diet in Renal Diseases (MDRD) equation. Cognitive function was evaluated with the Mini-Mental State Examination (MMSE) and Clinical Dementia Rating (CDR). Results A total of 84 patients (age mean ± SD, 86.6 ± 3.9 years) had MMSE scores of 10.1 ± 6.7, and CDR scores of 1.6 ± 0.7. The average eGFR was 61.7 ± 21.5 mL/min/1.73m2. The mean hemoglobin concentration was 12.7 ± 1.7 g/dl, and the mean albumin concentration was 4.5 ± 4.8 g/dl. Multivariate regression analyses showed that scores of CDR were significantly correlated with eGFR after adjustment for potential confounders. The scores of MMSE were significantly correlated with serum albumin and hemoglobin after adjustment for potential confounders. Conclusions We found dementia severity was significantly associated with kidney function, serum albumin, and hemoglobin in the oldest-old with AD. We recommend that oldest-old people with a diagnosis of AD be evaluated to determine kidney function, as well as nutritional and hematological status. Further study is needed to establish whether prevention of CKD deterioration, and correction of malnutrition and anemia may help to slow cognitive decline in oldest-old people with dementia.

show abstract

Section: Discussionmentioning

confidence: 99%

Effects of kidney function, serum albumin and hemoglobin on dementia severity in the oldest old people with newly diagnosed Alzheimer’s disease in a residential aged care facility: a cross-sectional study

Weng

Liang

et al. 2020

BMC Geriatr

View full text Add to dashboard Cite

show abstract

“…Anemia is prevalent in patients with chronic kidney disease (CKD) ( St Peter et al, 2018 ; Vestergaard et al, 2020 ; Wong et al, 2020 ; Hanna et al, 2021 ) and associated with an increased risk of progression of CKD, cardiovascular disease and mortality ( Thorp et al, 2009 ; Fishbane and Spinowitz, 2018 ; Shaker et al, 2018 ; Palaka et al, 2020 ). Correcting anemia is vital for reducing mortality and hospitalization and improving the life quality of CKD patients.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and Safety of Vadadustat for Anemia in Patients With Chronic Kidney Disease: A Systematic Review and Meta-Analysis

et al. 2022

View full text Add to dashboard Cite

Background: Vadadustat is a novel drug for treating anemia patients with chronic kidney disease (CKD), but its effect and safety remain uncertain. This study aimed to summarize the evidence for vadadustat in the treatment of CKD patients with anemia.Methods: PubMed, Ovid Medline, Embase, Cochrane CENTRAL, Wanfang Data, China National Knowledge Infrastructure and an international trial register were searched from their inception to June 2021 for randomized controlled trials (RCTs) comparing the efficacy and safety of vadadustat to those of placebo or erythropoiesis-stimulating agents (ESAs) in treating anemia in CKD patients. Data were pooled in a meta-analysis, with results expressed as the mean difference for continuous outcomes and relative risk for categorical outcomes with 95% confidence intervals (95% CIs). The certainty of evidence was rated according to Cochrane methods and the GRADE approach.Results: Ten RCTs comparing vadadustat with placebo (4 RCTs) or darbepoetin alfa (6 RCTs) were included (n = 8,438 participants). Compared with placebo, vadadustat increased the hemoglobin (Hb) response rate (risk ratio 5.27; 95% CI: 2.69 to 10.31; p < 0.001; high certainty of evidence) and Hb level from baseline (∆Hb) (mean difference (MD) 1.28; 95% CI: 0.83 to 1.73; p < 0.001; low certainty of evidence). Compared with placebo or darbepoetin alfa, vadadustat decreased hepcidin (MD -36.62; 95% CI: −54.95 to −18.30; p < 0.001) and ferritin (MD −56.24; 95% CI: −77.37 to −35.11; p < 0.001) levels and increased iron-binding capacity (MD 24.38; 95% CI: 13.69 to 35.07; p < 0.001), with a low to moderate certainty of evidence. Moderate to high certainty evidence suggested that compared with placebo or darbepoetin alfa, vadadustat significantly increased the risk of nausea and diarrhea but did not significantly increase the risk of serious adverse events, especially all-cause mortality, cardiac events and nonfatal stroke.Conclusion: Vadadustat may safely improve Hb levels and promote iron utilization in CKD patients with anemia without increasing the incidence of serious adverse events.

show abstract

“…Observational data indicate that anemia is associated with adverse outcomes in all disease states, including CKD [7][8][9][10][11][12][13][14][15]56 and congestive heart failure. 57 In CKD, anemia is associated with an increased risk of hospitalizations, cardiovascular disease, cognitive impairment, and mortality.…”

Section: Iron Anemia and Outcomes In Ckdmentioning

confidence: 99%

“…A nemia and iron deficiency are prevalent in patients with chronic kidney disease (CKD) [1][2][3][4][5][6] and associated with poor outcomes. [7][8][9][10][11][12][13][14][15] The 2012 Kidney Disease: Improving Global Outcomes (KDIGO) anemia guideline provides recommendations on the diagnosis and treatment of anemia in CKD, including the use of iron agents, erythropoiesis-stimulating agents (ESAs), and red cell transfusions. 16 Subsequently, based on evidence that full anemia correction with ESAs is associated with adverse outcomes, [17][18][19][20] and consequent regulatory and reimbursement changes in many countries, practice patterns have shifted toward reduced ESA use and increased iron supplementation.…”

mentioning

confidence: 99%

Controversies in optimal anemia management: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Conference

Babitt

Eisenga²,

Kshirsagar³

et al. 2021

Kidney International

144

108

View full text Add to dashboard Cite

Impact of correction of anemia in end-stage renal disease patients on cerebral circulation and cognitive functions

Cited by 13 publications

References 0 publications

Effects of kidney function, serum albumin and hemoglobin on dementia severity in the oldest old people with newly diagnosed Alzheimer’s disease in a residential aged care facility: a cross-sectional study

Effects of kidney function, serum albumin and hemoglobin on dementia severity in the oldest old people with newly diagnosed Alzheimer’s disease in a residential aged care facility: a cross-sectional study

Efficacy and Safety of Vadadustat for Anemia in Patients With Chronic Kidney Disease: A Systematic Review and Meta-Analysis

Controversies in optimal anemia management: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Conference

Contact Info

Product

Resources

About