Iron supplementation in anemia treatment

Abensur, Hugo; Castro, Manuel Carlos Martins

doi:10.5935/0101-2800.2014s005

Cited by 8 publications

(6 citation statements)

References 22 publications

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“…The global management of hemodialysis patients includes iron reserve monitoring as an essential component, because iron deficiency is closely associated with an inadequate response to ESA treatment ( 6 , 38 , 39 ). Our results reflected this relationship and demonstrated that increased serum iron was associated with diminished treatment resistance.…”

Section: Discussionmentioning

confidence: 99%

Epoetin alfa resistance in hemodialysis patients with chronic kidney disease: a longitudinal study

Santos

Hortegal²,

Serra

et al. 2018

Braz J Med Biol Res

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Anemia is an inevitable complication of hemodialysis, and the primary cause is erythropoietin deficiency. After diagnosis, treatment begins with an erythropoiesis-stimulating agent (ESA). However, some patients remain anemic even after receiving this medication. This study aimed to investigate the factors associated with resistance to recombinant human erythropoietin therapy with epoetin alfa (αEPO). We performed a prospective, longitudinal study of hemodialysis patients receiving treatment with αEPO at our reference hospital from July 2015 to June 2016. Clinical data was collected, and the response to αEPO treatment was evaluated using the erythropoietin resistance index (ERI). The ERI was defined as the weekly weight-adjusted αEPO dose (U/kg per week)/hemoglobin level (g/dL). A longitudinal linear regression model was fitted with random effects to verify the relationships between clinical and laboratory data and ERI. We enrolled 99 patients (average age, 45.7 (±17.6) years; male, 51.5%; 86.8% with hypertension). The ERI showed a significant positive association with serum ferritin and C-reactive protein, percentage interdialytic weight gain, and continuous usage of angiotensin receptor blocker (ARB) hypertension medication. The ERI was negatively associated with serum iron and albumin, age, urea reduction ratio, and body mass index. Our findings indicate that resistance to αEPO was related to a low serum iron reserve, an inflammatory state, poor nutritional status, and continuous usage of ARBs.

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Section: Discussionmentioning

confidence: 99%

Epoetin alfa resistance in hemodialysis patients with chronic kidney disease: a longitudinal study

Santos

Hortegal²,

Serra

et al. 2018

Braz J Med Biol Res

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“…Com os valores laboratoriais, adotou-se as seguintes referências de normalidade: <150 mg/dL para triglicerídeos; <190 mg/dL para colesterol total; <150 mg/dL para o LDL-c; <160 mg/dL para o não HDL-c 9 ; <100 mg/dL para glicemia 10 ; >40 mg/dL de HDL-c para mulheres e >50 mg/dL de HDL-c para homens 11 ; de 0,6 a 1,3 mg/dL para creatinina 12 ; de 15-45 mg/dL para ureia.…”

Section: Métodosunclassified

Perfil bioquímico de usuários diabéticos e hipertensos vinculados a Atenção Primária à Saúde

Melo

Nogueira

Kono

et al. 2023

Medicina (Ribeirão Preto)

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Introdução: O diabete mellitus (DM) e a hipertensão arterial sistêmica (HAS) são doenças crônicas não-transmissíveis que se associam a alto risco de mortalidade. Objetivo: Analisar o perfil laboratorial de pessoas com DM e HAS acompanhados na atenção primária à saúde. Método: Estudo descritivo e transversal, com a amostra de 345 pessoas em acompanhamento pelas estratégias de saúde da família pertencentes a duas Unidades Básicas de Saúde da zona urbana do município de Santarém, Pará, Brasil. Os participantes foram divididos em quatro grupos conforme diagnóstico: HAS; DM; ambas (DM-HAS); ou nenhuma (SEM). Foram coletadas informações socioeconômicas e clínicas dos participantes, com posterior coleta de sangue para as variáveis bioquímicas. Para a análise de dados foi realizada a estatística descritiva e inferencial, adotando-se significância de p<0,05. Resultados: Em todos os grupos predominaram participantes do sexo feminino, casados, pardos, com renda até dois salários, com 4-7 anos de estudo, não tabagistas e não estilistas. Em relação ao SEM, o DM se associou com valores alterados para glicose (p<0,0001), HDL-c (p=0,0481), ureia (p=0,0252), creatinina (p=0,0006) e hemoglobina (p=0,0024). Já o DM-HAS se associou com a presença de alteração para glicose (p<0,0001), ureia (p=0,0009), creatinina (p=0,0059) e taxa de filtração glomerular (p=0,0048). Conclusão: Conclui-se, conforme o método proposto, que a presença da DM e/ou HAS são capazes de modificar o perfil bioquímico de maneira negativa, bem como se ressalta a importância do acompanhamento desta pessoa pela atenção primária à saúde, visto que algumas pessoas apresentaram alterações bioquímicas que chamam atenção e não estão em acompanhamento.

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“…Renal biomarkers, such as neutrophil gelatinase-associated lipocalin (NGAL) and retinol-binding protein (RBP), have been used in the early identification of renal injury, especially in acute renal failure [15] and tubular dysfunction [16,17], signaling it even before the perception of the decrease in the glomerular filtration rate (GFR) associated with the increase in serum creatinine. They also appear to be potential biomarkers during therapy with nucles(t)ide analogs [18,19]…”

Section: Introductionmentioning

confidence: 99%

Renal dysfunction during treatment of chronic hepatitis B with tenofovir disoproxyl fumarate and associated risk factors

Maciel,

Ferraz,

Perez

et al. 2024

European Journal of Gastroenterology &Amp; Hepatology

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Objectives To analyze the evolution of glomerular filtration rate (GFR) and the presence of renal tubular dysfunction during the treatment of chronic hepatitis B virus (HBV) infection with tenofovir disoproxil fumarate (TDF) and to determine the risk factors involved. Methods Retrospective cohort observational study of adults with chronic hepatitis B. Exclusion: hepatitis C virus-HBV coinfection, diabetes, baseline GFR less than 60 ml/min. Measurements of serum and urinary creatinine and phosphate; urinary albumin, retinol-binding protein (RBP) and neutrophil gelatinase-associated lipocalin (NGAL) were performed. Univariate and multivariate analyses tracked factors associated with worsening GFR. Results A total of 120 individuals were included: 35% NAÏVE (G1); 49.2% HBV using TDF (G2); 15.8% HBV-HIV using TDF (G3); 63.3% men; 60.8% white; 30% hypertensive. Average age was 50.5 years (SD ± 12.9 years). Reactive HBeAg predominated in G3 (P < 0.001) and cirrhosis in G2 (P < 0.036). NGAL was elevated in 5.3% of cases (G1 = 3.2%; G2 = 8.7%; G3 = 0%; P = 0.582), RBP in 6.7% (G1, G3 = 0%; G2 = 13.6%; P = 0.012), urinary phosphate/creatinine ratio in 16.2% (G1 = 15.2%; G2 = 14.5%; G3 = 23.5%; P = 0.842) and urinary albumin/creatinine ratio in 12.9% (G1 = 12.2%; G2 = 10.7%; G3 = 21.1%; P = 0.494). Worsening of renal function occurred in 22.5% of the population (G1 = 11.9%; G2 = 28.8%; G3 = 26.3%; P = 0.122), independently associated only with systemic arterial hypertension [adjusted odds ratio (AOR) = 4.14; P = 0.008], but not to TDF (AOR = 2.66; P = 0.110) or male sex (AOR = 2.39; P = 0.135). However, the concomitance of these variables generated a high estimated risk for this outcome (51%). Conclusions Renal tubular dysfunction was uncommon according to NGAL, RBP or urinary phosphate/creatinine ratio. TDF was not an independent factor for worsening renal function, significantly associated only with systemic arterial hypertension. However, in hypertensive men, the use of TDF should be monitored.

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Iron supplementation in anemia treatment

Cited by 8 publications

References 22 publications

Epoetin alfa resistance in hemodialysis patients with chronic kidney disease: a longitudinal study

Epoetin alfa resistance in hemodialysis patients with chronic kidney disease: a longitudinal study

Perfil bioquímico de usuários diabéticos e hipertensos vinculados a Atenção Primária à Saúde

Renal dysfunction during treatment of chronic hepatitis B with tenofovir disoproxyl fumarate and associated risk factors

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