Renal anemia and hydration status in non-dialysis chronic kidney disease: Is there a link?
Autor: | Mariana Lipan, Ana Stanciu, Simona Stancu, Cristina Capusa |
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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 |
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