The anemia of chronic renal failure: Overview and early erythropoietin experience

Paganini, Emil P.; Garcia, J.; Abdulhadi, Mohamed H.; Lathim, Deborah; Giesman, Joan; Weick, James K.

doi:10.3949/ccjm.56.1.79

Cited by 3 publications

(2 citation statements)

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“…Available data indicate that there is an inverse correlation between red blood cell survival and serum blood urea nitrogen concentration. [18][19][20][21] In uremic patients, the normal response to hypoxemia is partially blunted. With initiation of dialysis, these patients usually show improvement in anemia symptoms and decreased transfusion requirements.…”

Section: Renal Failurementioning

confidence: 99%

Anemia of Critical Illness

Asare

2008

Pharmacotherapy

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Anemia of critical illness, a commonly encountered clinical situation, is hematologically similar to that of chronic anemia, except that the onset is generally sudden. The etiology is usually multifactorial, occurring as a consequence of direct inhibitory effects of inflammatory cytokines, erythropoietin deficiency, blunted erythropoietic response, blood loss, nutritional deficiencies, and renal insufficiency. Although anemia is not well tolerated by critically ill patients, aggressive treatment of anemia can be just as detrimental as no treatment. Different types of anemia may coexist in a patient in the intensive care unit, making diagnosis and differentiation among these anemias complex, therefore requiring good diagnostic skills. Although several therapeutic options are available to treat anemia, critically ill patients often receive a transfusion, and yet, most recent studies indicate that blood transfusions in critically ill patients are associated with worse outcomes, including higher morbidity and mortality. These studies have generated interest in the administration of exogenous erythropoietin and iron therapy. Unfortunately, the accurate determination of iron status can be a rather difficult task, an undertaking that is made even more difficult by the presence of comorbid conditions that can affect the commonly used parameters for guiding iron therapy. The use of erythropoiesis-stimulating agents is rapidly gaining acceptance, although they also present potential problems of their own.

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Section: Renal Failurementioning

confidence: 99%

Anemia of Critical Illness

Asare

2008

Pharmacotherapy

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“…In the past, pancytopenia with excessive transfusion requirements 10 or a large spleen along with splenomegaly aroused suspicion of hypersplenism 37 . Today, in selected patients, this diagnosis should still be kept in mind.…”

Section: Discussionmentioning

confidence: 99%

The spleen size in patients undergoing hemodialysis

Araújo

Suassuna

2021

Braz. J. Nephrol.

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Introduction: Inflammation promotes the progression of chronic renal failure, and the start of dialysis worsens inflammation. The enlargement of the spleen is associated with inflammation, and patients on hemodialysis may show a large spleen. The aim of the present study was to compare the spleen size of patients undergoing hemodialysis versus controls to update this thread. Methods: Controls and patients were eligible to participate in the study provided they were negative for serological markers of hepatitis B and C viruses and HIV, if they had no lymphoproliferative disorder, and if they were at least 18 years of age. Age, sex, and the duration of dialysis were recorded. Laboratory variables (hemoglobin, hematological cell count, serum creatinine) and the underlying cause of end-stage renal disease were analyzed. The spleen sizes of the patients were divided into tertiles. Results: The 75 controls and 168 patients selected were sex-matched. The patients were older, had larger spleens and lower platelet counts than controls. The relationship between spleen size and age in the controls and patients was quite similar. The patients in the first tertile of spleen size compared with those in the third were older and had a higher platelet counts. The underlying disease and dialysis vintage had no effect on spleen size. Discussion: The patients had larger spleens and a greater range of spleen sizes than the controls. In patients, the association between larger and smaller spleen with lower and higher platelet counts, respectively, sparked the speculation of occurrence of hypersplenism and hyposplenism.

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Anemia in the critically ill

Shander

2004

Critical Care Clinics

114

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The anemia of chronic renal failure: Overview and early erythropoietin experience

Cited by 3 publications

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Anemia of Critical Illness

Anemia of Critical Illness

The spleen size in patients undergoing hemodialysis

Anemia in the critically ill

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