Improving Erythropoiesis Stimulating Agent Hyporesponsiveness in Hemodialysis Patients: The Role of Hepcidin and Hemodiafiltration Online
| Autor: | Alberto Rosati, Vincenzo Panichi, Fiammetta Ravaglia |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
medicine.drug_class Anemia medicine.medical_treatment Iron 030232 urology & nephrology Disease Hemodiafiltration 030204 cardiovascular system & hematology law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial Hepcidins law Hepcidin hemic and lymphatic diseases medicine Humans Intensive care medicine Erythropoietin Randomized Controlled Trials as Topic biology business.industry Hematology General Medicine Erythropoiesis-stimulating agent medicine.disease Nephrology biology.protein Hematinics Observational study Hemodialysis business medicine.drug |
| Zdroj: | Blood purification. 45(1-3) |
| ISSN: | 1421-9735 |
| Popis: | Hyporesponsiveness to erythropoietin stimulating agents (ESAs) is a condition associated with increased mortality. Even after identifying the condition, the causes are difficult to treat and only partially reversible in end-stage renal disease patients. Thus, the role of more recent hemodialysis (HD) techniques in improving such conditions is an emerging issue. However, major randomized clinical trials have not confirmed the results of smaller observational studies in which online hemodiafiltration has shown some efficacy in improving patients’ response to ESAs. In our interpretation, these findings are not in contrast, but they can be explained by a better understanding of the interactions between HD and ESAs on iron mobilization, first of all through the role of hepcidin. The kinetics of hepcidin removal through HD combined with the action of selected ESAs may help the clinician in prescribing the best association between HD treatment and ESAs to overcome hyporesponsiveness. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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