Renal Function, Erythropoietin, and Anemia of Older Persons

Blé, Alessandro; Fink, Jeffrey C.; Woodman, Richard C.; Klausner, Mark A.; Windham, B. Gwen; Guralnik, Jack M.; Ferrucci, Luigi

doi:10.1001/archinte.165.19.2222

Cited by 114 publications

(61 citation statements)

References 21 publications

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“…In a previous study, we demonstrated that mild reduction of kidney function with creatinine clearance >0AE5 ml/s was not a significant risk factor for anaemia (Ble et al, 2005); (iii) those with Tfr/log(ferritin) ratio >1AE5 and/or ferritin <34 pmol/ml were classified as iron deficiency anaemia; (iv) those with low circulating iron (<10AE7 lmol/l) and no evidence of iron deficiency (Tfr/ log(ferritin) £1AE5 and ferritin ‡34 pmol/ml) were classified as anaemia of chronic disease, a condition characterised by reduced intestinal absorption and decreased macrophage release of iron, despite adequate or increased total iron stores (Andrews, 2004); (v) anaemic participants with folate (<5 nmol/l) or vitamin B12 (<150 pmol/l) deficiency were classified as 'B12/folate deficiency' anaemia (Chaves et al, 2004) and (vi) in accordance with Guralnik et al (1995), participants with anaemia and normal renal function, normal circulating iron and no iron, folate or vitamin B12 deficiency were classified as 'unexplained anaemia of ageing'.…”

Section: Discussionmentioning

confidence: 90%

Unexplained anaemia in older persons is characterised by low erythropoietin and low levels of pro‐inflammatory markers

Ferrucci

Guralnik

Bandinelli³

et al. 2007

Br J Haematol

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125

102

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SummaryEpidemiological studies report that a third of the cases of anaemia in older persons is unexplained. We compared erythropoietin (EPO), inflammatory markers and major comorbidities between older subjects with normal haemoglobin levels and those with different aetiologic forms of anaemia, including unexplained anaemia. Participants were a representative sample of 964 persons aged ≥65 years, with no evidence of bleeding, complete blood tests, and a complete blood count within 6 h of phlebotomy. Anaemia was defined as haemoglobin <130 g/l in men and 120 g/l in women, and classified as a result of chronic kidney disease, iron deficiency, chronic disease and B12/folate deficiency anaemia, or unexplained anaemia based on standard criteria. Of the 124 anaemic participants, 42 (36·8%) had unexplained anaemia. Participants with anaemia of chronic diseases had significantly higher interleukin‐6 (IL‐6) and C‐reactive protein (CRP) levels, while those with unexplained anaemia had significantly lower CRP than non‐anaemic controls. Iron deficiency anaemia was characterised by significantly higher EPO levels compared with other types of anaemia and normal haemoglobin, B12 and/or folate deficiency. Unexplained anaemia was characterised by unexpectedly low EPO and low lymphocyte count. Unexplained anaemia is associated with reduced kidney EPO response, low levels of pro‐inflammatory markers and low lymphocyte counts.

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Section: Discussionmentioning

confidence: 90%

Unexplained anaemia in older persons is characterised by low erythropoietin and low levels of pro‐inflammatory markers

Ferrucci

Guralnik

Bandinelli³

et al. 2007

Br J Haematol

Self Cite

125

102

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“…Moreover, a number of studies have suggested that aging is associated with dysregulation of pro-inflammatory c y t o k i n e s , i n p a r t i c u l a r I L -6 , w h i c h m a y a f f e c t erythropoiesis either by inhibition of EPO production or downregulation of EPO receptor expression (18)(19)(20).…”

Section: Introductionmentioning

confidence: 99%

Red cell distribution width and cancer

2016

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Red cell distribution width (RDW) is an index which primarily reflects impaired erythropoiesis and abnormal red blood cell survival. In last years the interest in this marker has considerably grown and now a lot of data are available indicating that this simple and inexpensive parameter is a strong and independent risk factor for death in the general population. Moreover, several investigations have been performed to investigate the role of RDW in cardiovascular and thrombotic disorders. Contrarily, there are relatively few reports focusing on RDW in the area of oncology and to date none review have been performed in this specific field. As such, the aim of this narrative review is to summarize some interesting results obtained in studies performed in patients affected by solid and hematological tumors. Even if larger studies are needed before these preliminary findings can be generalized, it seems plausible to affirm that RDW can be useful by adding prognostic information in patients with oncologic disease.

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“…34 Healthy elderly individuals exhibit relatively high serum EPO levels, which suggests a compensatory response to age-related subclinical blood loss, increased erythrocyte turnover or increased EPO resistance. 35 EPO levels are, however, unexpectedly suppressed in anemic elderly patients when compared with anemic young individuals, which suggests a blunted response to low hemoglobin levels.…”

Section: Endocrine Functionmentioning

confidence: 99%

Pathophysiology of the aging kidney and therapeutic interventions

2012

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Kidneys are among the organs affected by the aging process. Aging kidneys are characterized by progressive scarring and measurable declines in renal function. Deficiencies in renal function are associated with mortality in all populations. Therefore, if the kidneys age at an accelerated rate relative to the other organs in a particular individual, then slowing or reversing the kidney aging process may be a therapeutically useful strategy. In this review, we will discuss the physiology and pathogenesis of kidney aging and analyze potential therapeutic strategies for halting the aging process in the kidneys.

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Renal Function, Erythropoietin, and Anemia of Older Persons

Abstract: Severe age-related decline in renal function is associated with a reduced erythropoietin secretion and anemia. Whether moderate kidney impairment in older persons is associated with a progressively increasing risk of anemia remains to be determined.

Cited by 114 publications

References 21 publications

Unexplained anaemia in older persons is characterised by low erythropoietin and low levels of pro‐inflammatory markers

Unexplained anaemia in older persons is characterised by low erythropoietin and low levels of pro‐inflammatory markers

Red cell distribution width and cancer

Pathophysiology of the aging kidney and therapeutic interventions

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