Red Blood Cell Survival in Long-term Dialysis Patients

Vos, Frederiek E.; Schollum, John; Coulter, Carolyn V.; Doyle, Terence; Duffull, Stephen B.; Walker, Robert

doi:10.1053/j.ajkd.2011.03.031

Cited by 132 publications

(123 citation statements)

References 30 publications

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“…Onset of anemia associated with advancing DKD is linked to deficiencies of iron, folate, and erythropoietin, each of which can influence A1C levels. Therapy with erythrocytestimulating agents lowers A1C further, perhaps due to rapid changes in hemoglobin concentrations (63,64). Patients with eGFR levels ,60 mL/min/1.73 m 2 are more prone to hypoglycemia.…”

Section: Emerging Antihypertensive Therapiesmentioning

confidence: 99%

Diabetic Kidney Disease: A Report From an ADA Consensus Conference

Tuttle

Bakris

Bilous

et al. 2014

American Journal of Kidney Diseases

648

604

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The incidence and prevalence of diabetes mellitus have grown significantly throughout the world, due primarily to the increase in type 2 diabetes. This overall increase in the number of people with diabetes has had a major impact on development of diabetic kidney disease (DKD), one of the most frequent complications of both types of diabetes. DKD is the leading cause of end-stage renal disease (ESRD), accounting for approximately 50% of cases in the developed world. Although incidence rates for ESRD attributable to DKD have recently stabilized, these rates continue to rise in high-risk groups such as middle-aged African Americans, Native Americans, and Hispanics. The costs of care for people with DKD are extraordinarily high. In the Medicare population alone, DKD-related expenditures among this mostly older group were nearly $25 billion in 2011. Due to the high human and societal costs, the Consensus Conference on Chronic Kidney Disease and Diabetes was convened by the American Diabetes Association in collaboration with the American Society of Nephrology and the National Kidney Foundation to appraise issues regarding patient management, highlighting current practices and new directions. Major topic areas in DKD included 1) identification and monitoring, 2) cardiovascular disease and management of dyslipidemia, 3) hypertension and use of renin-angiotensin-aldosterone system blockade and mineralocorticoid receptor blockade, 4) glycemia measurement, hypoglycemia, and drug therapies, 5) nutrition and general care in advanced-stage chronic kidney disease, 6) children and adolescents, and 7) multidisciplinary approaches and medical home models for health care delivery. This current state summary and research recommendations are designed to guide advances in care and the generation of new knowledge that will meaningfully improve life for people with DKD.

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Section: Emerging Antihypertensive Therapiesmentioning

confidence: 99%

Diabetic Kidney Disease: A Report From an ADA Consensus Conference

Tuttle

Bakris

Bilous

et al. 2014

American Journal of Kidney Diseases

648

604

View full text Add to dashboard Cite

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“…Besides erythropoietin deficiency, and even in the presence of erythropoiesis stimulating agents, the reduced erythrocyte survival time is another important cause for anaemia in chronically haemodialysed patients. It is generally accepted that the toxic uremic environment accounts for the decreased erythrocyte life-span and this is not explained by mechanical damage from the dialysis membrane [20].…”

Section: Introductionmentioning

confidence: 99%

Ankyrin is the major oxidised protein in erythrocyte membranes from end-stage renal disease patients on chronic haemodialysis and oxidation is decreased by dialysis and vitamin C supplementation

Ruskovska

Bennett

Brown

et al. 2014

Free Radical Research

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Chronically haemodialysed end-stage renal disease patients are at high risk of morbidity arising from complications of dialysis, the underlying pathology that has led to renal disease and the complex pathology of chronic kidney disease. Anaemia is commonplace and its origins are multifactorial, involving reduced renal erythropoietin production, accumulation of uremic toxins and an increase in erythrocyte fragility.Oxidative damage is a common risk factor in renal disease and its co-morbidities, and is known to cause erythrocyte fragility. Therefore we have investigated the hypothesis that specific erythrocyte membrane proteins are more oxidised in endstage renal disease patients and that vitamin C supplementation can ameliorate membrane protein oxidation.Eleven patients and fifteen control subjects were recruited to the study. Patients were supplemented with 2 x 500mg vitamin C per day for four weeks. Erythrocyte membrane proteins were prepared pre-and post-vitamin C supplementation for determination of protein oxidation. Total protein carbonyls were reduced by vitamin C supplementation but not by dialysis when investigated by enzyme linked immunosorbent assay. Using a western blot to detect oxidised proteins, one protein band, later identified as containing ankyrin, was found to be oxidised in patients but not controls and was reduced significantly by 60% in all patients after dialysis and by 20% after vitamin C treatment pre-dialysis. Ankyrin oxidation analysis may be useful in a stratified medicines approach as a possible marker to identify requirements for intervention in dialysis patients.

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“…13,23 Shortened red blood cell survival also contributes, as demonstrated by radioisotope labeling studies. [23][24][25] Although the etiology is not entirely clear, metabolic and mechanical factors have been proposed. 23,24 Nutritional deficiencies, such as folate and vitamin B 12 , due to anorexia or dialysate losses are currently uncommon with the routine use of supplementation in hemodialysis patients.…”

mentioning

confidence: 99%

Mechanisms of Anemia in CKD

Babitt

Lin

2012

Journal of the American Society of Nephrology

806

691

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Anemia is a common feature of CKD associated with poor outcomes. The current management of patients with anemia in CKD is controversial, with recent clinical trials demonstrating increased morbidity and mortality related to erythropoiesis stimulating agents. Here, we examine recent insights into the molecular mechanisms underlying anemia of CKD. These insights hold promise for the development of new diagnostic tests and therapies that directly target the pathophysiologic processes underlying this form of anemia.

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Red Blood Cell Survival in Long-term Dialysis Patients

Cited by 132 publications

References 30 publications

Diabetic Kidney Disease: A Report From an ADA Consensus Conference

Diabetic Kidney Disease: A Report From an ADA Consensus Conference

Ankyrin is the major oxidised protein in erythrocyte membranes from end-stage renal disease patients on chronic haemodialysis and oxidation is decreased by dialysis and vitamin C supplementation

Mechanisms of Anemia in CKD

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