Archive for the ‘Anemia’ Category

May 29, 2016

The Effect of Erythropoietin-Stimulating Agents on Health-Related Quality of Life in Anemia of Chronic Kidney Disease: A Systematic Review and Meta-analysis

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This meta-analysis and systematic review of 17 studies showed that higher hemoglobin targets did not result in statistically or clinically significant differences in SF-36 or KDQ domains.  Furthermore, HRQOL were further attenuated in studies at low risk of bias and in subgroups of dialysis patients.    

No Comments Posted in Anemia, Clinical Nephrology
January 28, 2013

Peginesatide in Patients with Anemia Undergoing Hemodialysis

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Peginesatide, a synthetic peptide-based erythropoiesis-stimulating agent (ESA), administered monthly, was as effective as epoetin, administered 1 to 3 times per week, in maintaining hemoglobin levels in patients undergoing hemodialysis. See the accompanying article on outcomes in CKD patients: http://www.nejm.org/doi/full/10.1056/NEJMoa1203166 See the accompanying editorial: http://www.nejm.org/doi/full/10.1056/NEJMe1215043

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September 18, 2012

KDIGO Clinical Practice Guideline for Anemia in Chronic Kidney Disease

These clinical practice guidelines provide guidance on anemia management in CKD and ESRD.

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February 26, 2012

Testosterone deficiency is a cause of anemia and reduced responsiveness to erythropoiesis-stimulating agents in men with chronic kidney disease

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This observational study assessed a) the association between testosterone levels and hemoglobin in nondialysed CKD Stages 1-5 ESA-naive male patients as well as the association between testosterone levels and ESA dose in ESA-treated males undergoing hemodialysis.  CKD patients with lower testosterone values were 5.3 times more likely to be anemic.  In patients undergoing HD, higher […]

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May 10, 2011

Intravenous Erythropoietin in Patients With ST-Segment Elevation Myocardial Infarction: REVEAL: A Randomized Controlled Trial

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This randomized controlled trial in non-CKD patients with STEMI examined the impact of a single intravenous bolus of epoetin alfa within 4 hours of PCI.  The intervention group did not have any reduction in infarct size and was associated with higher rates of adverse cardiovascular events. Should this trial impact how Nephrologists prescribe ESA in CKD […]

1 Comment Posted in Anemia, Internal Medicine for Nephrologists
March 15, 2011

Naturally Occurring Higher Hemoglobin Concentration Does Not Increase Mortality among Hemodialysis Patients

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This prospective, observational Dialysis Outcomes and Practice Patterns Study which examined 29,796 hemodialysis patients demonstrates and reassures that naturally occurring hemoglobin concentration >120 g/L is not associated with increased mortality. Free full text kindly provided by American Society of Nephrology.

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March 15, 2011

Bundled Payment for ESRD — Including ESAs in Medicare’s Dialysis Package

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This NEJM Perspective article discusses the implementation and implication of bundled Medicare reimbursement for ESRD therapy in the United States.

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November 1, 2010

Erythropoietic Response and Outcomes in Kidney Disease and Type 2 Diabetes

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This study assessed the relationship between initial responsiveness to darbepoetin alfa and outcomes in patients with chronic kidney disease and type 2 diabetes mellitus. A poor initial hematopoietic response was associated with an increased risk of death or cardiovascular events.

1 Comment Posted in Anemia, Chronic Kidney Disease
August 20, 2010

High Dose Epoetin Beta in the First Weeks Following Renal Transplantation and Delayed Graft Function: Results of the Neo-PDGF Study

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Erythropoietin has nephroprotective effects in a variety of animal models, including against ischemia-reperfusion injury, which is an important element of delayed graft function. In this multi-center randomized trial, patients were randomized to four doses of erythropoietin or placebo in the first two weeks post-transplant. There ws no difference in the rate of delayed graft function […]

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June 6, 2010

TREAT: Implications for Guideline Updates and Clinical Care

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This editorial provides practical suggestions on how to translate the results of TREAT into clinical practice.

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June 6, 2010

Systematic Review: Erythropoiesis-Stimulating Agents in Patients With Chronic Kidney Disease

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This meta-analysis confirms that targeting higher hemoglobin levels in CKD increases risks for stroke, hypertension, and vascular access thrombosis and probably increases risks for death, serious cardiovascular events, and end-stage renal disease.

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June 6, 2010

Anemia Management in Chronic Kidney Disease: Bursting the Hemoglobin Bubble

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This editorial summarizes the management of anemia post-TREAT, but also asks critical questions that remain to be clarified in this important area.

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May 1, 2010

The FDA’s Perspective on the Risk for Rapid Rise in Hemoglobin in Treating CKD Anemia: Quo Vadis

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In response to the publication of “Trial to Reduce Cardiovascular Endpoints with Aranesp Therapy” (TREAT), the US Food and Drug Administration has elected to reevaluate the use of erythropoiesis-stimulating agents in the treatment of anemia secondary to chronic kidney disease. This commentary by Dr. Ajay Singh provides insight into the challenges involved with interpreting the […]

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