The Use of Erythropoiesis-Stimulating Agents in Patients With CKD and Cancer: A Clinical Approach

Thavarajah, Sumeska; Choi, Michael

doi:10.1053/j.ajkd.2019.04.022

Cited by 27 publications

(29 citation statements)

References 47 publications

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“…EPO is a hypoxia-induced hormone produced by the kidney and fetal liver which can stimulate hematopoiesis in the bone marrow. Since obtained Food and Drug Administration (FDA) license for clinical use, EPO and its analogs rHu-EPO have been used for treatment of the anemias caused by chronic renal failure, malignancies and proved to be effective [22,23]. In recent years, EPO has captured the attention of surgeons for its excellent efficacy in improving perioperative anemia caused by massive blood loss [24].…”

Section: Discussionmentioning

confidence: 99%

Does subcutaneous administration of recombinant human erythropoietin increase thrombotic events in total hip arthroplasty? A prospective thrombelastography analysis

et al. 2020

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Background Anemia is one of severe complications in the perioperative period of total hip arthroplasty (THA). Erythropoietin (EPO) has been considered to improve patients’ anemia state, but its efficiency and safety remains controversial. Methods A total of 152 patients who underwent total hip arthroplasty from January 2017 to March 2019 were randomized to 2 groups. Recombinant human erythropoietin (rHu-EPO) group was treated with rHu-EPO subcutaneous injection 10000 IU after operation and once daily in the next week, while control group was treated with none extra treatment. Routine hematologic examination and thrombelastography (TEG) performed at different time point respectively. Doppler ultrasound for bilateral lower limbs was performed 1 day before surgery and 7 days after surgery. Auxiliary examination outcomes, blood transfusions outcomes, and postoperative complications were recorded as assessment indicators. Results The difference in the relevant indexes of traditional coagulation and TEG values between two groups were not significantly. No significant difference was observed in the incidence of thromboembolism events and other complications between two groups during postoperative period. The amount of intraoperative blood loss was similar between the two groups. However, the postoperative use and dosage of allogeneic blood in the rHu-EPO group were lower than those in the control group. The hemoglobin and hematocrit level in the rHu-EPO group were higher than that in the control group after surgery. Conclusion Postoperative subcutaneous injection of rHu-EPO can improve hematological anemia-related parameters, reduce the use and dosage of allogeneic blood transfusions (ABTs), and has no significant influence on the formation of thrombosis and other complications in patients undergoing total hip arthroplasty in short term.

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Section: Discussionmentioning

confidence: 99%

Does subcutaneous administration of recombinant human erythropoietin increase thrombotic events in total hip arthroplasty? A prospective thrombelastography analysis

et al. 2020

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“…68 Meta-analysis data from 2009 have suggested treatment with ESAs in patients with cancer increases mortality and worsens overall survival 69 ; however, a 2012 meta-analysis of 91 trials with more than 20,000 participants failed to show a direct impact of ESAs on cancer disease progression. 70 In a recent article, Thavarajah and Choi 71 underscored that while current evidence suggests ESAs may promote progression or worsen outcomes in some cancers, there are no data on the likelihood of developing new cancers in patients undergoing dialysis or those in earlier stages of CKD during ESA therapy.…”

Section: Managing Renal Toxicities From Treatmentsmentioning

confidence: 99%

KDIGO Controversies Conference on onco-nephrology: understanding kidney impairment and solid-organ malignancies, and managing kidney cancer

Porta

Bamias

Danesh

et al. 2020

Kidney International

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“…Chronic kidney disease (CKD), cancers, inflammatory diseases, nutritional deficiencies, genetic disorders, and drugs may cause anemia. Erythropoiesis-stimulating agents (ESAs), including recombinant erythropoietin (EPO) analogs, have been used for treating anemia associated with CKD through compensating for decreased EPO [ 1 , 2 , 3 ]. However, resistance and tolerance to these drugs have been shown to develop, and high doses of ESAs can cause side effects such as cardiovascular diseases [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

HIF-α Prolyl Hydroxylase Inhibitors and Their Implications for Biomedicine: A Comprehensive Review

Hirota

2021

Biomedicines

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Oxygen is essential for the maintenance of the body. Living organisms have evolved systems to secure an oxygen environment to be proper. Hypoxia-inducible factor (HIF) plays an essential role in this process; it is a transcription factor that mediates erythropoietin (EPO) induction at the transcriptional level under hypoxic environment. After successful cDNA cloning in 1995, a line of studies were conducted for elucidating the molecular mechanism of HIF activation in response to hypoxia. In 2001, cDNA cloning of dioxygenases acting on prolines and asparagine residues, which play essential roles in this process, was reported. HIF-prolyl hydroxylases (PHs) are molecules that constitute the core molecular mechanism of detecting a decrease in the partial pressure of oxygen, or hypoxia, in the cells; they can be called oxygen sensors. In this review, I discuss the process of molecular cloning of HIF and HIF-PH, which explains hypoxia-induced EPO expression; the development of HIF-PH inhibitors that artificially or exogenously activate HIF by inhibiting HIF-PH; and the significance and implications of medical intervention using HIF-PH inhibitors.

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The Use of Erythropoiesis-Stimulating Agents in Patients With CKD and Cancer: A Clinical Approach

Cited by 27 publications

References 47 publications

Does subcutaneous administration of recombinant human erythropoietin increase thrombotic events in total hip arthroplasty? A prospective thrombelastography analysis

Does subcutaneous administration of recombinant human erythropoietin increase thrombotic events in total hip arthroplasty? A prospective thrombelastography analysis

KDIGO Controversies Conference on onco-nephrology: understanding kidney impairment and solid-organ malignancies, and managing kidney cancer

HIF-α Prolyl Hydroxylase Inhibitors and Their Implications for Biomedicine: A Comprehensive Review

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