المؤلفون: Sofroniadou, Sofia, Kassimatis, Theodoros, Goldsmith, David

المصدر: Sofroniadou , S , Kassimatis , T & Goldsmith , D 2010 , ' Anaemia, microcytosis and sirolimus-is iron the missing link? ' , Nephrology, Dialysis, Transplantation , vol. 25 , no. 5 , pp. 1667-1675 . https://doi.org/10.1093/ndt/gfp674Test

مصطلحات موضوعية: iron, microcytosis, post-transplantation anaemia, sirolimus, RENAL-TRANSPLANT RECIPIENTS, POSTTRANSPLANTATION ANEMIA, PRIMARY IMMUNOSUPPRESSION, ALLOGRAFT RECIPIENTS, ERYTHROPOIESIS, EXPERIENCE, EVEROLIMUS, DEFICIENCY, RAPAMYCIN, ADULT

الوصف: Background. Sirolimus (SRL) has been implicated in the causation of post-transplantation anaemia (PTA). It also induces profound red blood cell (RBC) microcytosis, which is poorly understood. Methods. We conducted a retrospective study of SRL-induced anaemia and microcytosis [mean corpuscular volume (MCV) <80 fl] with specific reference to iron homeostasis in 93 renal transplant patients treated with SRL for at least 3 months. Results. While mean haemoglobin (Hb) and use of erythropoiesis-stimulating agents increased on SRL, RBC MCV underwent a significant decline throughout the whole study period of 24 months (P <0.001) with the percentage of microcytosis rising from 2.2% at the start of SRL therapy to 40.7% after 24 months of therapy. An association between dMCV (MCV change on SRL) and SRL levels was shown at 3, 6, 12 and 24 months post-SRL (P = 0.015, P = 0.037, P = 0.002 and P = 0.001, respectively). Intravenous (IV) iron administration was an independent predictor of dMCV at 12 and 24 months on SRL (P = 0.031 and P = 0.048, respectively). All patients who, after starting SRL and seeing a fall in MCV, then went on to receive IV iron therapy, showed a marked increase in MCV; this did not happen to patients given oral iron therapy. Conclusions. SRL is associated with mild anaemia, but marked RBC microcytosis-these phenomena are correlated with SRL levels and the use of IV iron. Functional iron deficiency and impaired gastrointestinal absorption of iron seem likely explanations.

الإتاحة: https://doi.org/10.1093/ndt/gfp674Test
https://kclpure.kcl.ac.uk/portal/en/publications/8985dc2a-2a81-4ab8-b30c-610d7b2b4910Test

المؤلفون: Penny, Hugo, Leckstroem, Daniel, Goldsmith, David

المصدر: Penny , H , Leckstroem , D & Goldsmith , D 2013 , ' The Janus faces of ESAs : caveat Chimaera! ' , International Urology and Nephrology , vol. 45 , no. 3 , pp. 761-767 . https://doi.org/10.1007/s11255-012-0270-5Test

مصطلحات موضوعية: Epoetin, Erythropoietin, Mortality, Transplantation, Anemia, KIDNEY-TRANSPLANT RECIPIENTS, DELAYED GRAFT FUNCTION, RENAL-TRANSPLANTATION, DARBEPOETIN-ALPHA, RANDOMIZED-TRIAL, DISEASE, ERYTHROPOIESIS, PREDICTORS

الوصف: Patients with chronic kidney disease (CKD) have a Janus quality as they look back whence they came in developing CKD and, in some cases, also look forwards to a potential kidney transplant with the attendant promise of improvement in quality and often quantity of life. Making the most of this often unique opportunity is key-maximising the chance that the engraftment starts as a success, and then later, preserving good kidney transplant function for as long as possible. Two recently published, independently conceived and executed studies are relevant to both aspects of this quest and thus to all kidney transplant recipients (KTRs). Both trials also simultaneously stoke and quench the continuing, heated debates over target haemoglobin (Hb) levels, and the use of erythropoiesis-stimulating agents (ESAs), in CKD patients. One study-of acute, high-dose ESA administration-adds to the plethora of adverse safety signals swirling around the use of ESAs while surprisingly also showing renal function benefits at 12 months. The other study features chronic lower-dose ESA use in stable KTRs with anaemia and impaired renal function and not only purports to show a salutary effect on 2-year renal function outcomes (and thus reducing "return to dialysis" rates), but also rebuts the now widely accepted current notion that by chronic use of ESAs to target full Hb correction/higher Hb values in anaemic CKD patients, we are potentially causing harm.

الإتاحة: https://doi.org/10.1007/s11255-012-0270-5Test
https://kclpure.kcl.ac.uk/portal/en/publications/54dbe505-9804-4d51-a91d-74bd75fc6dd9Test

المؤلفون: Shah, Nilesh, Al-Khoury, Salam, Afzali, Behdad, Covic, Adrian, Roche, Alison, Marsh, James, Macdougall, Iain C, Goldsmith, David J A

المصدر: Shah , N , Al-Khoury , S , Afzali , B , Covic , A , Roche , A , Marsh , J , Macdougall , I C & Goldsmith , D J A 2006 , ' Posttransplantation anemia in adult renal allograft recipients : prevalence and predictors ' , Transplantation , vol. 81 , no. 8 , pp. 1112-1118 . https://doi.org/10.1097/01.tp.0000205174.97275.b5Test

مصطلحات موضوعية: Adult, Aged, Anemia, Angiotensin II Type 1 Receptor Blockers, Angiotensin-Converting Enzyme Inhibitors, C-Reactive Protein, Cohort Studies, Cross-Sectional Studies, Erythropoiesis, Female, Ferritins, Glomerular Filtration Rate, Humans, Kidney Transplantation, Male, Middle Aged, Prevalence, Regression Analysis, Transplantation, Homologous

الوصف: Management of anemia is an important factor in the care of patients with chronic kidney disease as the anemic state can confer significant morbidity and mortality. Posttransplantation anemia (PTA) has received comparatively less attention in the literature, and the prevalence and predictors of PTA vary between different studies. The purpose of this study was to investigate a large posttransplant population from 3 centres in the UK to elucidate the point prevalence of PTA, its determinants and the use of erythropoiesis stimulating agents (ESA) in these patients.

الإتاحة: https://doi.org/10.1097/01.tp.0000205174.97275.b5Test
https://kclpure.kcl.ac.uk/portal/en/publications/f6be3433-ea0a-4438-845e-b0ac5103907eTest

المؤلفون: Afzali, Ben, Al-Khoury, Salam, Shah, Nilesh, Mikhail, Ashraf, Covic, Adrian, Goldsmith, David

المصدر: Afzali , B , Al-Khoury , S , Shah , N , Mikhail , A , Covic , A & Goldsmith , D 2006 , ' Anemia after renal transplantation ' , American journal of kidney diseases : the official journal of the National Kidney Foundation , vol. 48 , no. 4 , N/A , pp. 519-536 . https://doi.org/10.1053/j.ajkd.2006.07.006Test

مصطلحات موضوعية: Anemia, Iron-Deficiency, Cardiovascular Diseases, Erythropoiesis, Erythropoietin, Humans, Kidney Failure, Chronic, Kidney Transplantation, Prevalence, Recombinant Proteins, Risk Factors

الوصف: Anemia in the setting of chronic kidney disease is a well-recognized phenomenon that is associated with decreasing renal function and deficiency of or resistance to erythropoietin. However, anemia in the post-renal transplantation setting has received comparatively less attention in the literature. In this review, we aim critically to appraise the available literature regarding posttransplantation anemia, concentrating in particular on the prevalence of posttransplantation anemia, its etiopathogenesis, potential effects on morbidity and mortality, and the rationale for intervention and treatment. Despite deficiencies in the literature, we conclude that posttransplantation anemia is a common phenomenon that can occur either early or late posttransplantation, and its causation is usually multifactorial and includes contributions notably from poor or decreasing renal function, immunosuppression, and iron deficiency. Conversely, there is a shortage of well-conducted prospective studies looking at the morbidity attributable to posttransplantation anemia and a lack of trial evidence to determine whether intervention improves patient morbidity and outcome.

الإتاحة: https://doi.org/10.1053/j.ajkd.2006.07.006Test
https://kclpure.kcl.ac.uk/portal/en/publications/a4a97008-9d27-4690-bc28-f5e0ac4f9091Test

المؤلفون: Locatelli, Francesco, Bárány, Peter, Covic, Adrian, De Francisco, Angel, Del Vecchio, Lucia, Goldsmith, David, Hörl, Walter, London, Gerard, Vanholder, Raymond, Van Biesen, Wim

المصدر: Nephrology Dialysis Transplantation; Jun2013, Vol. 28 Issue 6, p1346-1359, 14p

مصطلحات موضوعية: HEALTH outcome assessment, TREATMENT of chronic kidney failure, CHRONIC kidney failure, CLINICAL trials, DEATH rate, ERYTHROPOIESIS, PATIENTS

مستخلص: Recently, the Kidney Disease: Improving Global Outcomes (KDIGO) group has produced comprehensive clinical practice guidelines for the management of anaemia in CKD patients. These guidelines addressed all of the important points related to anaemia management in CKD patients, including therapy with erythropoieis stimulating agents (ESA), iron therapy, ESA resistance and blood transfusion use. Because most guidelines were ‘soft’ rather than ‘strong’, and because global guidelines need to be adapted and implemented into the regional context where they are used, on behalf of the European Renal Best Practice Advisory Board some of its members, and other external experts in this field, who were not participants in the KDIGO guidelines group, were invited to participate in this anaemia working group to examine and comment on the KDIGO documents in this position paper. In this article, the group concentrated only on those guidelines which we considered worth amending or adapting. All guidelines not specifically mentioned are fully endorsed. [ABSTRACT FROM AUTHOR]

: Copyright of Nephrology Dialysis Transplantation is the property of Oxford University Press / USA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Bennett, Charles L., Spiegel, David M., Macdougall, Iain C., Norris, LeAnn, Qureshi, Zaina P., Sartor, Oliver, Lai, Stephen Y., Tallman, Martin S., Raisch, Dennis W., Smith, Sheila Weiss, Silver, Samuel, Murday, Alanna S., Armitage, James O., Goldsmith, David

المصدر: Seminars in Thrombosis & Hemostasis; Nov2012, Vol. 38 Issue 8, p783-796, 14p

مصطلحات موضوعية: ERYTHROPOIESIS, DARBEPOETIN alfa, DRUG therapy, ANEMIA, MYOCARDIAL infarction

مصطلحات جغرافية: UNITED States, EUROPE

مستخلص: The erythropoiesis-stimulating agents (ESAs) erythropoietin and darbepoetin prevent transfusions among chemotherapy-associated anemia patients. Clinical trials, meta-analyses, and guidelines identify mortality, tumor progression, and venous thromboembolism (VTE) risks with ESA administration in this setting. Product labels advise against administering ESAs with potentially curative chemotherapy (United States) or to conduct risk-benefit assessments (Europe/Canada). Since 2007, fewer chemotherapy-associated anemia patients in the United States and Europe receive ESAs. ESAs and the erythropoietin receptor agonist peginesatide prevent transfusions among chronic kidney disease (CKD) patients; clinical trials, guidelines, and meta-analyses demonstrate myocardial infarction, stroke, VTE, or mortality risks with ESAs targeting high hemoglobin levels. U.S. labels recommend administering ESAs or peginesatide at doses sufficient to prevent transfusions among dialysis CKD patients. For dialysis CKD patients, Canadian and European labels recommend targeting hemoglobin levels of 10 to 12 g/dL and 11 to 12 g/dL, respectively, with ESAs. ESA utilization for dialysis CKD patients has decreased in the United States. [ABSTRACT FROM AUTHOR]

: Copyright of Seminars in Thrombosis & Hemostasis is the property of Thieme Medical Publishing Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Mactier, Robert, Davies, Simon, Dudley, Chris, Harden, Paul, Jones, Colin, Kanagasundaram, Suren, Lewington, Andrew, Richardson, Donald, Taal, Maarten, Andrews, Peter, Baker, Richard, Breen, Cormac, Duncan, Neill, Farrington, Ken, Fluck, Richard, Geddes, Colin, Goldsmith, David, Hoenich, Nic, Holt, Stephen, Jardine, Alan

المصدر: Nephron Clinical Practice; May2011 Supplement, Vol. 118, pc27-c70, 44p

مصطلحات موضوعية: KIDNEY diseases, CLINICAL medicine, ERYTHROPOIESIS, CARDIOVASCULAR diseases, ANEMIA

مستخلص: The article presents summary of the Renal Association Clinical Practice Guidelines for 2009-2012, on topics that relates chronic kidney disease (CKD) to anaemia, cardiovascular disease, and mineral and bone disorder. It mentions that proteinuria and haemoglobin must be assessed annually in patients treated for CKD. Also, patients with anaemia of CKD must be offered with Erythropoiesis Stimulating Agents (ESAs). Patients with a history of cardiovascular disease have diabetes, stroke, and angina.

المؤلفون: Molnar, Miklos Zsolt, Mucsi, Istvan, Macdougall, Iain C., Marsh, James E., Yaqoob, Magdi, Main, John, Courtney, Aisling E., Fogarty, Damien, Mikhail, Ashraf, Choukroun, Gabriel, Short, Colin D., Covic, Adrian, Goldsmith, David J.

المصدر: Nephron Clinical Practice; Jan2011, Vol. 117 Issue 2, pc127-c134, 8p, 2 Charts, 3 Graphs

مصطلحات موضوعية: KIDNEY transplantation, RENAL anemia, ERYTHROPOIESIS, HEMOGLOBINS, CROSS-sectional method, ANALYSIS of variance

مصطلحات جغرافية: EUROPE

مستخلص: Background: Although it is a known predictor of mortality, there is a relative lack of recent information about anaemia in kidney transplant recipients. Thus, we now report data about the prevalence and management of post-transplant anaemia (PTA) in Europe 5 years after the TRansplant European Survey on Anemia Management (TRESAM) study. Methods: In a cross-sectional study enrolling the largest number of patients to date, data were obtained from 5,834 patients followed at 10 outpatient transplant clinics in four European countries using the American Society of Transplantation anaemia guideline. Results: More than one third (42%) of the patients were anaemic. The haemoglobin (Hb) concentration was significantly correlated with the estimated glomerular filtration rate (eGFR) (r = 0.4, p < 0.001). In multivariate analysis, eGFR, serum ferritin, age, gender, time since transplantation and centres were independently and significantly associated with Hb. Only 24% of the patients who had a Hb concentration <110 g/l were treated with an erythropoiesis-stimulating agent. The prevalence of anaemia and also the use of erythropoiesis-stimulating agents were significantly different across the different centres, suggesting substantial practice variations. Conclusions: PTA is still common and under-treated. The prevalence and management of PTA have not changed substantially since the TRESAM survey. Copyright © 2010 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

: Copyright of Nephron Clinical Practice is the property of Karger AG and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Goldsmith, David¹ David.Goldsmith@gstt.nhs.uk, Covic, Adrian²

المصدر: Nephrology Dialysis Transplantation. Jun2010, Vol. 25 Issue 6, p1734-1737. 4p.

مصطلحات موضوعية: *ANEMIA treatment, *ERYTHROPOIESIS, *KIDNEY diseases, *GLOMERULAR filtration rate, *PATIENTS

مستخلص: The authors reflect on the time to reconsider evidence for Anaemia treatment (TREAT) study and utilization of erythropoiesis-stimulating agents (ESAs) in nephrology. The study involves patients who have diagnosed with diseases such as anaemia, chronic kidney disease, and type 2 diabetes. It uses an estimated glomerular filtration rate (eGFR) and haemogoblin in diagnosis of patients with diabetes. Findings of the study show the absence of cardiovascular or renal benefit in ESA-treated patients.

المؤلفون: Mikhail, Ashraf, Covic, Adrian, Goldsmith, David

المصدر: Kidney & Blood Pressure Research; 2008, Vol. 31 Issue 4, p234-246, 13p, 2 Diagrams, 2 Charts

مصطلحات موضوعية: ERYTHROPOIESIS, RECOMBINANT erythropoietin, ANEMIA, ERYTHROPOIETIN, PEPTIDES

مستخلص: The introduction of recombinant human erythropoietin (rHuEpo) nearly 20 years ago has revolutionised the management of patients with CKD, providing the opportunity for safe long-term anaemia correction without the attendant risks identified with blood products. Based on our expanding knowledge in this area, there are many exciting and innovative new approaches to anaemia correction that stand on, or are close to, the threshold of yielding products ready for clinical use. Recently, an Epo-related molecule called continuous Epo receptor activator has been licensed in Europe, and other molecules are in various processes of development, including Epo mimetic peptide. The search goes on for orally active antianaemic therapies, and several strategies are being investigated. Furthermore, it is now clear that in addition to the anaemia-correction properties of erythropoiesis-stimulating agents, there is the potential for cytoprotection by prevention of cellular apoptosis. This effect could be used in the prevention of ischaemia-reperfusion injury as well as other conditions associated with acute kidney injury and other disease processes. The aim of this article is to discuss these possible future strategies, focusing in particular on those with a reasonable likelihood of a pharmaceutical product that is likely to be used clinically. Copyright © 2008 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

: Copyright of Kidney & Blood Pressure Research is the property of Karger AG and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)