Intravascular hemolysis in patients with mitral regurgitation: Evaluation by erythrocyte creatine

Sugiura, Tetsuro; Okumiya, Toshika; Kamioka, Mikio; Kubo, Toru; Hirakawa, Yoko; Hisahara, Taisuke; Matsumura, Yuichi

doi:10.1016/j.jjcc.2017.10.006

Cited by 7 publications

(10 citation statements)

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“…An excellent correlation between erythrocyte creatine content and direct measurement of red blood cell survival time by 51 Cr method has been reported [ 12 , 13 ]. In patients with normal erythropoietic capacity such as intravascular haemolysis and haemolytic anaemia, red cell production is accelerated in proportion to the amount of erythrocyte destruction, which lead to an increase in the young erythrocytes containing higher erythrocyte creatine levels [ 26 – 29 ]. In contrast, renal anaemia is mainly caused by decreased erythropoietic capacity due to inadequate erythropoietin production and/or hyporesponsiveness to ESA treatment [ 6 , 30 ].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of recombinant human erythropoietin responsiveness by measuring erythrocyte creatine content in haemodialysis patients

et al. 2021

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Background One of the main causes of anaemia in patients with end-stage renal disease is relative deficiency in erythropoietin production. Eythropoiesis stimulating agent (ESA), a potent haematopoietic growth factor, is used to treat anaemia in haemodialysis patients. The effect of ESA is usually assessed by haematological indices such as red blood cell count, haemoglobin concentration and haematocrit, but erythrocyte indices do not provide information of the rapid change in erythropoietic activity. As erythrocyte creatine directly assess erythropoiesis, the aim of this study was to evaluate the effect of ESA in haemodialysis patients by measuring the erythrocyte creatine content. Methods ESA dose was fixed 3 months prior to the enrollment and was maintained throughout the entire study period. Erythrocyte creatine was measured with haematologic indices in 83 haemodialysis patients. Haemoglobin was also measured 3 months after. Results ESA dose (152.4 ± 62.9 vs. 82.2 ± 45.5 units/kg/week, P = 0.0001) and erythrocyte creatine (2.07 ± 0.73 vs. 1.60 ± 0.41 μmol/gHb, p = 0.0003) were significantly higher in 27 patients with haemoglobin <10 g/dL compared to 56 patients with haemoglobin ≥10 g/dL. There was a fair correlation between ESA dose and the concentration of creatine in the erythrocytes (r = 0.55, P < 0.0001). Increase in haemoglobin (>0.1 g/dL) was observed in 37 patients, whereas haemoglobin did not increase in 46 patients. Erythrocyte creatine levels were significantly higher in those patients with an increase in haemoglobin compared to those without (2.04 ± 0.64 vs. 1.52 ± 0.39 μmol/gHb, p < 0.0001). When 8 variables (ESA dose, erythropoietin resistance index, C-reactive protein, intact parathyroid hormone, iron supplementation, presence of anaemia, erythrocyte creatine and reticulocyte) were used in the multivariate logistic analysis, erythrocyte creatine levels emerged as the most important variable associated with increase in haemoglobin (Chi-square = 6.19, P = 0.01). Conclusion Erythrocyte creatine, a useful marker of erythropoietic capacity, is a reliable marker to estimate ameliorative effectiveness of ESA in haemodialysis patients.

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Section: Discussionmentioning

confidence: 99%

Evaluation of recombinant human erythropoietin responsiveness by measuring erythrocyte creatine content in haemodialysis patients

et al. 2021

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“…An excellent correlation between erythrocyte creatine and direct measurement of red blood cell survival time by 51 Cr method has been reported [12,13]. In patients with normal erythropoietic capacity such as intravascular haemolysis and haemolytic anaemia, red cell production is accelerated in proportion to the amount of erythrocyte destruction, which lead to an increase in the young erythrocytes containing higher erythrocyte creatine levels [26][27][28][29]. In contrast, renal anaemia is mainly caused by decreased erythoropoietic capacity due to inadequate erythropoietin production and/or hypoesponsiveness to rHuEpo treatment [6,30].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Recombinant Human Erythropoietin Responsiveness by Erythrocyte Creatine in Haemodialysis Patients

Hasegawa

Nakamura

Sugiura

et al. 2021

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Background: One of the main causes of anaemia in patients with end-stage renal disease is relative deficiency in erythropoietin production. Recombinant human erythropoietin (rHuEpo), a potent haematopoietic growth factor, is used to treat anaemia in haemodialysis patients. The effect of rHuEpo is usually assessed by haematological indices such as red blood cell count, haemoglobin concentration and haematocrit, but erythrocyte indices do not provide information of the rapid change in erythropoietic activity. As erythrocyte creatine directly assess erythropoiesis, the aim of this study was to evaluate the effect of rHuEpo in haemodialysis patients by measuring erythrocyte creatine. Methods: rHuEpo dose was fixed 3 months prior to the enrollment and was maintained throughout the entire study period. Eerythrocyte creatine was measured with haematologic indices in 83 haemodialysis patients. Haemoglobin was also measured 3 months after. Results: rHuEpo dose (152.4±62.9 vs. 82.2±45.5 units/kg/week, P=0.0001) and erythrocyte creatine (2.07±0.73 vs. 1.60±0.41 µmol/gHb, p=0.0003) were significantly higher in 27 patients with haemoglobin <10g/dL compared to 56 patients with haemoglobin ≥10g/dL. There was a fair correlation between rHuEpo dose and erythrocyte creatine (r=0.55, P <0.0001). Increase in haemoglobin (>0.1g/dL) was observed in 37 patients, whereas haemoglobin did not increase in 46 patients. Erythrocyte creatine was significantly higher in patients with increase in haemoglobin compared to those without (2.04±0.64 vs. 1.52±0.39 µmol/gHb, p <0.0001). When 8 variables (rHuEpo dose, erythropoietin resistance index, C-reactive protein, intact parathyroid hormone, incidence of iron deficiency, presence of anaemia, erythrocyte creatine and reticulocyte) were used in the multivariate logistic analysis, erythrocyte creatine emerged as the most important variable associated with increase in haemoglobin (Chi-square=6.19, P=0.01). Conclusion: Erythrocyte creatine, a useful marker of erythropoietic capacity, is a reliable marker to estimate ameliorative effectiveness of rHuEpo in haemodialysis patients.

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“…Young erythrocytes contain substantially higher creatine levels than older erythrocytes and creatine contents in erythrocytes decrease gradually with advancing cell age [10][11][12]. Accelerated red cell production, which lead to an increase in the young erythrocytes results in red cells containing higher erythrocyte creatine levels and hence, erythrocyte creatine level reflects average or cumulative erythropoiesis [13][14][15][16][17][18][19]. In patients with normal erythropoietic capacity such as intravascular haemolysis and haemolytic anaemia, red cell production is accelerated in proportion to the amount of erythrocyte destruction, which lead to an increase in the young erythrocytes with higher erythrocyte creatine levels [13][14][15][16][17].…”

Section: Introductionmentioning

confidence: 99%

“…Accelerated red cell production, which lead to an increase in the young erythrocytes results in red cells containing higher erythrocyte creatine levels and hence, erythrocyte creatine level reflects average or cumulative erythropoiesis [13][14][15][16][17][18][19]. In patients with normal erythropoietic capacity such as intravascular haemolysis and haemolytic anaemia, red cell production is accelerated in proportion to the amount of erythrocyte destruction, which lead to an increase in the young erythrocytes with higher erythrocyte creatine levels [13][14][15][16][17]. In contrast, renal anaemia is mainly caused by decreased erythropoietic capacity due to inadequate erythropoietin production [20][21][22][23][24][25].…”

Section: Introductionmentioning

confidence: 99%

Diagnostic accuracy and clinical usefulness of erythrocyte creatine content to predict the improvement of anaemia in patients receiving maintenance haemodialysis

et al. 2023

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Background The improvement of anaemia over time by erythropoiesis stimulating agent (ESA) is associated with better survival in haemodialysis patients. We previously reported that erythrocyte creatine content, a marker of erythropoietic capacity, was a reliable marker to estimate the effectiveness of ESA. The aim of this study was to examine the accuracy and clinical usefulness of erythrocyte creatine content to predict the improvement of anaemia in haemodialysis patients. Methods ESA dose was fixed 3 months prior to the enrollment and was maintained throughout the study period. Erythrocyte creatine content and haematologic indices were measured at baseline in 92 patients receiving maintenance haemodialysis. Haemoglobin was also measured 3 months after. Improvement of anaemia was defined as ≥ 0.8 g/dL change in haemoglobin from baseline to 3 months. Results Erythrocyte creatine content was significantly higher in 32 patients with improvement of anaemia compared to 60 patients with no improvement of anaemia (2.47 ± 0.74 vs. 1.57 ± 0.49 μmol/gHb, P = 0.0001). When 9 variables (erythrocyte creatine content, ESA dose, reticulocyte, haptoglobin, haemoglobin at baseline, serum calcium, intact parathyroid hormone, transferrin saturation and serum ferritin) were used in the multivariate logistic regression analysis, erythrocyte creatine emerged as the most important variable associated with the improvement of anaemia (P = 0.0001). The optimal cut-off point of erythrocyte creatine content to detect the improvement of anaemia was 1.78 μmol/gHb (Area under the curve: 0.86). Sensitivity and specificity of erythrocyte creatine content to detect the improvement of anaemia were 90.6% and 83.3%. Conclusion Erythrocyte creatine content is a reliable marker to predict the improvement of anaemia 3 months ahead in patients receiving maintenance haemodialysis.

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Intravascular hemolysis in patients with mitral regurgitation: Evaluation by erythrocyte creatine

Abstract: Intravascular hemolysis associated with subclincal anemia in patients with eccentric jet was due to the destruction of erythrocyte by collision of the eccentric jet to the atrial wall.

Cited by 7 publications

References 30 publications

Evaluation of recombinant human erythropoietin responsiveness by measuring erythrocyte creatine content in haemodialysis patients

Evaluation of recombinant human erythropoietin responsiveness by measuring erythrocyte creatine content in haemodialysis patients

Evaluation of Recombinant Human Erythropoietin Responsiveness by Erythrocyte Creatine in Haemodialysis Patients

Diagnostic accuracy and clinical usefulness of erythrocyte creatine content to predict the improvement of anaemia in patients receiving maintenance haemodialysis

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