Renal anemia and hydration status in non-dialysis chronic kidney disease: Is there a link?

Autor: Mariana Lipan, Ana Stanciu, Simona Stancu, Cristina Capusa
Rok vydání: 2018
Předmět:
ESA: Erythropoiesis stimulating agents
Male
030232 urology & nephrology
Organism Hydration Status
030204 cardiovascular system & hematology
Kidney
Kidney Function Tests
Gastroenterology
ESKD: End-stage kidney disease
Hemoglobins
Hemoglobin: Hb
0302 clinical medicine
Chronic Kidney Disease
Epo: Erythropoietin(s)
Prevalence
(e)GFR: (Estimated) Glomerular filtration rate
BCM: Body composition monitor
Fluid overload
Hemoglobin
biology
Anemia
OH: Overhydration
General Medicine
Iron deficiency
Middle Aged
CKD: Chronic kidney disease
Original Article
Female
CRP: C-reactive protein
medicine.drug
medicine.medical_specialty
Renal function
03 medical and health sciences
Renal Dialysis
Internal medicine
medicine
Humans
Renal Insufficiency
Chronic
Serum Albumin
business.industry
Transferrin saturation
medicine.disease
CVD: Cardiovascular diseases
Ferritin
Cross-Sectional Studies
Erythropoietin
TSAT: Transferrin saturation
biology.protein
Hemoglobin
business
Iron deficiency
Renal anemia
Kidney disease
Zdroj: Journal of Medicine and Life
ISSN: 1844-3117
1844-122X
Popis: Rationale Anemia, a common feature in chronic kidney disease (CKD), has multiple contributors to its pathogenesis. Besides the well recognized erythropoietin and iron deficiencies, hydration status might be involved. Objective To assess the prevalence and correlations of anemia, iron deficiency and overhydration in patients with stage 2 to 5 CKD. Methods and Results This cross-sectional study enrolled 125 erythropoietin and iron therapy naïve non-dialysis CKD patients, without a identifiable cause of anemia. Parameters of hematological, iron, inflammatory and nutritional status were measured. The overhydration parameter (OH) assessed by bioimpedance spectroscopy was used to characterize hydration status. The prevalence of decreased hemoglobin (Hb) p=0.008). Fluid overload (OH >1L) and lower serum albumin (pp=0.02, respectively), suggesting a potential dilutional reduction in serum proteins. Conversely, decreased iron stores (ferritin Hemoglobin was positively correlated with estimated glomerular filtration rate (eGFR), serum albumin, and transferrin saturation, but inversely with OH. However, in a model of multiple linear regression which explained 32% of hemoglobin variation, only eGFR and overhydration remained the independent predictors of anemia. Discussion As fluid overload is a common denominator for hemoglobin and TSAT levels, and is closely related to the declining kidney function, it should be considered in the management of renal anemia, at least in advanced CKD.
Databáze: OpenAIRE
Externí odkaz: