Red blood cell transfusion, hyperkalemia, and heart failure in advanced chronic kidney disease

Gill, Karminder S.; Fink, Jeffrey C.; Gilbertson, David T.; Monda, Keri L.; Muntner, Paul; Lafayette, Richard A.; Petersen, Jeffrey; Chertow, Glenn M.; Bradbury, Brian D.

doi:10.1002/pds.3779

Cited by 5 publications

(3 citation statements)

References 44 publications

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“…Actually, two observational studies in anemic HF patients demonstrated that patients receiving blood transfusions had a worse clinical outcome and prognosis [286]. Also in anemic patients with advanced CKD, blood transfusions were shown to cause hyperkalemia and heart failure [287]. Finally, numerous meta-analyses in cancer patients have demonstrated an increased mortality, morbidity and risk for tumor recurrence in patients receiving blood transfusions [255].…”

Section: Blood Transfusionsmentioning

confidence: 99%

Physiology and Inflammation Driven Pathophysiology of Iron Homeostasis—Mechanistic Insights into Anemia of Inflammation and Its Treatment

et al. 2021

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Anemia is very common in patients with inflammatory disorders. Its prevalence is associated with severity of the underlying disease, and it negatively affects quality of life and cardio-vascular performance of patients. Anemia of inflammation (AI) is caused by disturbances of iron metabolism resulting in iron retention within macrophages, a reduced erythrocyte half-life, and cytokine mediated inhibition of erythropoietin function and erythroid progenitor cell differentiation. AI is mostly mild to moderate, normochromic and normocytic, and characterized by low circulating iron, but normal and increased levels of the storage protein ferritin and the iron hormone hepcidin. The primary therapeutic approach for AI is treatment of the underlying inflammatory disease which mostly results in normalization of hemoglobin levels over time unless other pathologies such as vitamin deficiencies, true iron deficiency on the basis of bleeding episodes, or renal insufficiency are present. If the underlying disease and/or anemia are not resolved, iron supplementation therapy and/or treatment with erythropoietin stimulating agents may be considered whereas blood transfusions are an emergency treatment for life-threatening anemia. New treatments with hepcidin-modifying strategies and stabilizers of hypoxia inducible factors emerge but their therapeutic efficacy for treatment of AI in ill patients needs to be evaluated in clinical trials.

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Section: Blood Transfusionsmentioning

confidence: 99%

Physiology and Inflammation Driven Pathophysiology of Iron Homeostasis—Mechanistic Insights into Anemia of Inflammation and Its Treatment

et al. 2021

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“…Exposure to transfusion was identified by International Classification of Disease-9th Revision Clinical Modification procedure and diagnosis codes, Healthcare Common Procedure Coding System, and current procedural terminology codes by using established methods (Table A3). 17,18…”

Section: Study Populationmentioning

confidence: 99%

Changes in the use of erythropoiesis‐stimulating agents (ESAs) and red blood cell transfusion in patients with cancer amidst regulatory and reimbursement changes

Gawade

Berlin

Henry

et al. 2017

Pharmacoepidemiology and Drug

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“…[ 9 ] However, under complex conditions, such as diabetes plus hypertension, autohemotherapy may cause hyperkalemia according to a study showed that RBC transfusion is associated with an elevated risk of hyperkalemia and heart failure in patients with advanced CKD. [ 10 ]…”

Section: Discussionmentioning

confidence: 99%

Ozone therapy induced sinus arrest in a hypertensive patient with chronic kidney disease

et al. 2017

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Rationale:Ozone autohemotherapy as an alternative treatment method has been applied to the treatment of several diseases. Here, we report a patient used ozone autohemotherapy to treat her hypertension and diabetes. Nevertheless, the patient occurred sudden dizziness and black haze due to hyperkalemia.Patient concerns:A 54-year-old woman who was admitted to our emergency department complaining of sudden dizziness and black haze for 5 hours.Diagnoses:The blood potassium test showed hyperkalemia. Upon further inquiry of her medical history, the patient received ozone autohemotherapy to treat hypertension and diabetes for 9 days prior to admission.Interventions:The ozone therapy had been asked to stop. Insulin, sodium bicarbonate, and sodium polystyrene sulfonate were administered to the patient.Outcomes:After treatment, blood potassium remained in the normal range. After 3 days of treatment, the 24-hour dynamic electrocardiogram revealed sinus rhythm with an average heart rate of 82 beats/min, occasional ventricular premature beats, occasional ventricular premature beats, and no ST segment depression.Lessons:Although ozone therapy is widely used in the treatment of several diseases, adverse reactions should be given attention in clinical practice, especially in patients with chronic kidney disease.

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Red blood cell transfusion, hyperkalemia, and heart failure in advanced chronic kidney disease

Abstract: In patients with advanced CKD, RBC transfusion appears to be associated with an elevated risk of hyperkalemia and heart failure; further investigation into these risks is warranted.

Cited by 5 publications

References 44 publications

Physiology and Inflammation Driven Pathophysiology of Iron Homeostasis—Mechanistic Insights into Anemia of Inflammation and Its Treatment

Physiology and Inflammation Driven Pathophysiology of Iron Homeostasis—Mechanistic Insights into Anemia of Inflammation and Its Treatment

Changes in the use of erythropoiesis‐stimulating agents (ESAs) and red blood cell transfusion in patients with cancer amidst regulatory and reimbursement changes

Ozone therapy induced sinus arrest in a hypertensive patient with chronic kidney disease

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