Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0002871 (anemia)
 52,094 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Recombinant erythropoietin was used in the treatment of the anemic syndrome in 5 patients (4 women and 1 man), aged 45-63, with confirmed autosomal dominant polycystic kidney disease. All patients were with II stage chronic renal insufficiency. The treatment was conducted with Eprex (Silag, Switzerland) administered subcutaneously in a dose of 50 U/kg of body weight for three months. Once weekly, hemoglobin, hematocrit, erythrocytes, and serum iron were investigated in all patients. Simultaneously, we used recombinant erythropoietin in the same dose and treatment protocol on a control group of 3 women and 2 men with II stage chronic renal insufficiency but without polycystic kidney disease. The control patients were suffering from other diseases leading to uremia. In both groups, the hemoglobin and hematocrit were found to be significantly increased whereas their serum iron tended to decrease which required inclusion of iron containing preparations in the treatment. We found no significant differences both in the dynamics of influencing the disease and in the final results of the treatment with erythropoietin between the patients with polycystic kidney diseases and those without polycystosis and chronic renal insufficiency. No allergic reactions were observed during treatment. Arterial pressure was elevated in all patients. We think that recombinant erythropoietin can be used successfully in the treatment of renal anemia in patients with polycystic kidney disease and chronic renal insufficiency in the predialysis stage.
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PMID:Application of recombinant human erythropoietin in patients with polycystic kidney disease and chronic renal failure. 133 66

The cost-effectiveness of epoetin alfa therapy for anemia in 20 patients with end-stage renal disease was retrospectively studied. Ten patients on continuous ambulatory peritoneal dialysis (CAPD) were given subcutaneous epoetin alfa as part of a multicenter, protocol-controlled study of the efficacy of epoetin alfa. Ten patients on in-center hemodialysis were given intravenous epoetin alfa as part of their routine clinical care. Change in hematocrit was used as the measure of effectiveness of epoetin alfa. Medication, laboratory, and transfusion costs were monitored for the six months preceding the initiation of epoetin alfa and the first six months of treatment. The cost of therapy increased for all patients by an average of $2722 +/- 1118; transfusion costs decreased, whereas medication and laboratory costs increased. Laboratory costs were significantly greater in CAPD patients than in hemodialysis patients during epoetin alfa therapy; no significant differences in medication costs or transfusion costs were noted between the groups. The mean increase in hematocrit for all patients was 7.4 volume percent. Following the initial change in hematocrit, further therapeutic response did not appear to be determined by increasing expenditures. Epoetin alfa was shown to be effective in treating anemia in patients with end-stage renal disease, but it was associated with higher costs of therapy.
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PMID:Cost-effectiveness of epoetin alfa therapy for anemia of end-stage renal disease. 152 88

Maintaining adequate hematocrit levels in patients with end-stage renal disease can help alleviate the symptoms of anemia and improve quality of life. The effects of Epoetin alfa on hematocrit are described, and patient assessment and management are emphasized.
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PMID:Case management of the anemic patient. Epoetin alfa: focus on hematocrit. 154 90

Epoetin alfa therapy has been proven effective in treating anemia in dialysis patients; it increases the hematocrit (HCT) and improves the quality of life. The reimbursement policy for Epoetin alfa therapy is very important to dialysis patients; nurses need to understand the policy to help patients with reimbursement and to comply with the provisions for patient monitoring and education.
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PMID:Case management of the anemic patient. Epoetin alfa: focus on reimbursement. 158 34

Dialysis efficiency has traditionally been measured using kinetic modeling (KT/Vurea). However, once anemia is corrected with Epoetin alfa, using urea as the only measure of dialysis effectiveness may not be adequate. Two case studies describe the use of the urea kinetic model and other means of assessing dialysis efficiency in nonanemic patients.
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PMID:Case management of the anemic patient. Epoetin alfa: focus on dialysis efficiency. 175 Jul 93

Six patients with acute renal failure, in five cases due to acute crescentic glomerulonephritis and in one case due to total bilateral renal cortical necrosis, were studied. All had serum erythropoietin (EPO) concentrations in the normal range, despite a relatively severe anaemia. Half-life and plasma clearance of intravenously injected recombinant human erythropoietin (rhEPO) were determined. The results indicate that the lack of compensatory increase in serum EPO to the anaemic stimulus is not due to increased catabolism, but to decreased synthesis of the renal hormone. Two patients were treated with rhEPO (Eprex). In marked contrast to untreated controls, both patients responded with vigorous reticulocytosis and normalization of haemoglobin levels while they were still in severe renal failure. These results are similar to our previous findings in patients with acute renal failure due to tubular necrosis. Under all three conditions the defective EPO synthesis is probably the dominant pathogenetic factor for the largely aregeneratory anaemia of prolonged cases, and for the sluggish restoration of red cell mass during recovery of renal function. It is concluded that defective synthesis of EPO is not only a permanent and irreversible feature of severe chronic renal failure, but that it is also present, usually in a transient and reversible form, in different types of acute renal failure.
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PMID:Erythropoietin deficiency in acute crescentic glomerulonephritis and in total bilateral renal cortical necrosis. 202 90

Predialysis patients often suffer from debilitating anemia, which is evident through reduced exercise tolerance, weakness, and fatigue as well as lowered hematocrit (HCT). As has been shown in dialysis populations, the anemia of predialysis patients can be treated successfully using Epoetin alfa therapy. Therapy with Epoetin alfa allows patients to resume many of their normal activities and treats the anemia without the need for blood transfusion. The nephrology nurse plays a multifactorial role in the physiologic monitoring and counseling of these patients.
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PMID:Nursing care of predialysis patients receiving epoetin alfa. 206 56

Cardiac function of dialysis patients improves when severe anemia is corrected with Epoetin alfa. Direct clinical changes include a decrease in cardiothoracic ratio and diminished left ventricular size. Exercise-induced cardiac ischemia as noted by depression of the S-T segment on EKG is also reduced. Nephrology nurses must monitor hemodynamic changes, provide patient reeducation, and encourage patient compliance with medication regimens.
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PMID:Case management of the anemic patient. Focus on hemodynamics. 206 57

As the use of Epoetin alfa to treat the anemia of chronic renal failure expands, attention is beginning to focus on the dietary changes that may occur subsequent to therapy. The anemia-related pattern of poor appetite, lethargy, and decreased mental and physical status can often be reversed as anemia is corrected. Changes in nutritional status increase the importance of monitoring serum chemistries and providing timely interventions. Potentially serious side effects associated with changes in serum chemistries can be minimized or prevented by a teamwork approach involving the physician, nurse, and renal dietitian.
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PMID:Case management of the anemic patient. Epoetin alfa: focus on nutrition management. 224 Dec 57

Nursing management of anemic dialysis patients requires a thorough understanding of the conditions that can potentially affect erythropoiesis. Erythropoietin deficiency has been documented as the primary cause of the anemia of uremia, and Epoetin alfa has proven to be an effective therapy for correcting this condition. However, other etiologies, independent of the uremic process, can also contribute to anemia in these patients and lead to a diminished response to Epoetin alfa. Iron deficiency and blood loss, for example, are well-documented etiologies that can hinder erythropoiesis and diminish the response to Epoetin alfa (Van Wyck, 1989). Another etiology still under investigation is the potential effect of infection or inflammation on the response to Epoetin alfa. This article examines the anemia of infection and inflammation and the potential effect on response to Epoetin alfa.
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PMID:Case management of the anemic patient. Epoetin alfa: focus on inflammation and infection. 225 31


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