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)

The anemia associated with end-stage renal disease (ESRD) is primarily due to a deficiency in renal-derived erythropoietin. Through advances in genetic engineering, the gene for erythropoietin has been isolated and cloned, and recombinant human erythropoietin (r-HuEPO; EPOGEN, AMGEN Inc, Thousand Oaks, CA) is now available for clinical use. Study results indicate that r-HuEPO is highly effective in ameliorating symptomatic anemia in patients with chronic renal failure. Sustained dose-dependent increases in hematocrit values are achieved in at least 97% of patients, with improvement in quality of life, exercise tolerance, decrease in total body iron stores, and virtual elimination (40-fold reduction) of transfusion requirements. Hypertension is the most common side effect, but is easily controlled. To date, anti-erythropoietin antibodies have not been detected in patients treated with this product. Doses between 100 and 150 U/kg body weight are sufficient to increase hematocrit levels to normal in 2 months or less, with iron replacement therapy needed in most patients. The correction of anemia in ESRD patients promotes an increase in appetite, causing ingestion of more protein, potassium, and sodium. The resulting need for increased dialysis may burden existing dialysis facilities. Experience with 36 patients receiving r-Hu-EPO demonstrates that high-flux short-time hemodialysis is as effective as conventional hemodialysis. There were no significant differences between the groups in laboratory parameters including blood urea nitrogen, creatinine, potassium, phosphate, mean arterial pressure, and weight loss, although hematocrit values were slightly higher in the high-flux dialysis patients. Adverse effects resulting from r-HuEPO treatment were minor and were not more common in the group receiving high-flux short-time hemodialysis.
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PMID:Clinical efficacy of recombinant human erythropoietin in hemodialysis patients. 264 16

The chemistry, pharmacology, pharmacokinetics, clinical uses and efficacy, adverse effects, drug interactions, dosage and administration, and formulary considerations of epoetin are described. Erythropoietin, a glycoprotein hormone primarily synthesized in the kidney, is the chief regulator of red blood cell production. Erythropoietin concentrations increase in response to a hypoxic state, resulting in increased red blood cell formation, accelerated hemoglobin production, and premature movement of reticulocytes into the circulation. The human gene responsible for the production of erythropoietin recently was cloned, and the recombinant product--epoetin--has been made available through mass production. The apparent volume of distribution of i.v. epoetin approximates the assumed plasma volume both in healthy volunteers and in patients with chronic renal failure. Little is known about the metabolism and route of elimination of epoetin and erythropoietin. Epoetin recently was approved by the FDA for treatment of anemia associated with chronic renal failure. Clinical trials in patients receiving hemodialysis or peritoneal dialysis and in predialysis patients with renal dysfunction demonstrate epoetin's efficacy. Other potential indications include augmentation of blood production in patients enrolled in autologous blood donation programs and treatment of anemias associated with rheumatoid arthritis, sickle cell disease, acquired immunodeficiency syndrome, cancer, and premature birth. The most frequent adverse effect associated with epoetin therapy is the worsening or development of hypertension. Other adverse effects include thrombocytosis, hyperkalemia, rise in serum urea concentration, iron deficiency, and flu-like symptoms. No drug interactions with epoetin have been reported in humans. The recommended starting epoetin dosage in patients with chronic renal failure is 50-100 IU/kg three times weekly. Epoetin is available only as an injection for i.v. or s.c. administration. Epoetin provides a new therapeutic approach to the treatment of anemia associated with chronic renal failure in hemodialysis, peritoneal dialysis, and predialysis patients. Benefits of epoetin therapy include reduced need for blood transfusions, the amelioration of anemic symptoms, and an improved quality of life.
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PMID:Epoetin: human recombinant erythropoietin. 268 Feb 41

A clinical review of patients who were treated with recombinant human erythropoietin was undertaken to evaluate the effect of partial correction of anemia upon dialysis function and waste retention. Assessment of possible variables that might influence the dosage response was also undertaken, both in a retrospective and prospective manner. Finally, a chart review of patients' symptoms while on dialysis was done to evaluate the effect of correction of anemia. Hematologic improvement was noted in all patients placed on hormone therapy with the correction of hemoglobin and hematocrit. There was no effect on white cell count, although a slight change in the differential was noted at target and one year; platelets rose to a new steady state. Dialysis efficiency was decreased slightly for urea and markedly for creatinine, probable reflecting the distribution characteristics of the latter. Retention of urate, phosphorus, and potassium was noted at target, with a drop toward usual serum levels with minimal dialysis prescription change. Variables such as age, gender, race, and dialysis prescription were compared in an effort to establish dosage variation, but no statistically significant changes were seen. There was an inverse trend in dosage, however, with increasing dialysis efficiency. Patients also seemed to be more tolerant of their dialysis treatments when nonanemic, compared to when anemic. While there is retention of some substances with improvement of anemia, the levels were easily corrected with adjustment of the dialysis prescription. No definite relationship could be seen in any of the variables studied and hormone dose requirements. Attention must be paid to adequate dialysis prescription in the erythropoietin treated patient.
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PMID:Recombinant human erythropoietin correction of anemia. Dialysis efficiency, waste retention, and chronic dose variables. 268 18

Parameters of renal function were evaluated in severe malarial infection, using mice infected with Plasmodium berghei. When 7-week-old male BALB/c mice were inoculated with 1 x 10(7) P. berghei NK65-infected red blood cells, the rodents died an average of 7.4 days after inoculation. Anemia developed on day 5 after inoculation and progressed markedly on days 6 and 7. Plasma urea nitrogen increased rapidly on day 6 or 7, after which death occurred within 24 h. In contrast, urinary urea nitrogen excretion decreased on the same day. Urinary beta-N-acetyl-D-glucosaminidase (NAG) activity increased from day 3 to day 5, then decreased to normal levels on day 7. Renal ATP concentration and energy charge decreased markedly on day 7. These data indicate that the blood oxygen supply to the tissues began to decrease on day 6 and that renal insufficiency developed in the terminal stage of infection. We concluded that even a moderate increase in the level of plasma urea nitrogen could be a useful index of renal insufficiency in this infection system.
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PMID:Significance of blood urea nitrogen as an index of renal function in mice infected with Plasmodium berghei. 269 68

Haematological and biochemical studies were done for 50 urban and rural Egyptians, from Cairo, suffering from Ancylostoma duodenale, Ascaris lumbricoides, Enterobius vermicularis, Hymenolepis nana, Schistoosma mansoni and Taenia saginata. Anaemia of varying degrees was noticed in all cases. The lowest Hb% and hematocrit value and highest eosinophilia were found in cases of ancylostomiasis with severe hypochromia compared with the other parasitic infections. Total blood protein was normal in all cases, except in 2 cases of S. mansoni, it was higher. Blood cholesterol and blood urea showed no deviation.
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PMID:A study on intestinal helminths causing human anaemia in Cairo. 270 58

Acute toxic nephropathy was produced in 6 healthy goats by injecting intravenously 1% uranyl nitrate (UN) (15 mg/kg body weight). The early painful clinical signs simulating shock progressed with subnormal temperature, slow-shallow respiration and arrhythmic pulse followed by death due to respiratory failure within 96 to 120 hr. All the affected goats had normocytic normochromic anemia, leucocytosis, neutrophilia with left shift eosinopenia, decreased monocytes and presence of 1-2% reticulocytes in the peripheral blood smears. On blood chemical analysis, a uniform and continuous rise was seen in serum creatinine with a concomitant daily increase of serum urea and uric acid. Simultaneous analysis of urine indicated polyuria leading to oliguria, acidic pH, albuminuria, glycosuria with presence of neutrophils, RBC's, epithelial and fatty casts, increase of triple phosphate, and cystine crystals reflecting acute damage of kidneys in the affected goats.
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PMID:Clinico-biochemical studies on acute toxic nephropathy in goats due to uranyl nitrate. 271 8

Anemia is an almost invariable feature of chronic renal failure and is particularly severe in children treated by long-term hemodialysis. Recombinant human erythropoietin (rhEPO) offers entirely new aspects in the treatment of renal anemia. This report presents three patients on maintenance hemodialysis aged 10, 10/10 12, and 18 years who were treated with rhEPO. Two suffered from hemochromatosis secondary to multiple transfusions. 100 U/kg rhEPO were administered three times weekly, and venesection after dialysis was performed when a target hematocrit value of 30% was achieved. Hematocrit, reticulocyte-counts and hemoglobin rose within 3 to 6 weeks after initiation of therapy in all patients. Serumferritin levels declined significantly in the two patients with hemochromatosis. No deterioration of the metabolic status (i.e. increase of blood urea nitrogen, serum-creatinine, -phosphate or -potassium) could be detected. Therapy had to be discontinued in one patient who experienced hypertensive ceisis. This patient, however, had suffered from severe hypertension prior to rhEPO therapy. Blood pressure remained stable in the other patients. We conclude that renal anemia can be effectively treated by rhEPO in children. Increase of blood pressure may necessitate discontinuation of therapy especially in primary hypertensive patients. Extensive studies are necessary to eluciate long-term effects of rhEPO in children.
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PMID:[Treatment of renal anemia with recombinant human erythropoietin]. 271 49

Analyses of prognostic factors have allowed the design of staging systems in different haematological disorders. In a series of 220 patients with multiple myeloma, univariate analysis showed that nine parameters had a significant adverse effect on survival; poor performance status (Karnowsky scaling system less than 70%), infections before diagnosis, renal impairment (assessed either by creatinine clearance greater than 2 mg dl-1 or urea greater than 40 mg dl-1), serum calcium (greater than 10 mg dl-1), severe anaemia (less than 8.5 g dl-1), the presence of Bence-Jones proteinuria, failure to achieve complete remission, more than 40% plasma cells in bone marrow and a low paraprotein index (monoclonal component/% plasma cells: P less than 0.09). In addition, this index correlated significantly with all the other prognostic factors except performance status. The best combination of disease characteristics selected by means of the Cox regression proportional hazards method were performance status and creatinine levels. Additionally, by factor analysis of principal components we obtained a regression equation that included creatinine levels, haemoglobin, performance status and paraprotein index. Using this it was possible to separate the series of patients into three risk categories: A (65 patients), B (69 patients) and C (65 patients) with a median survival of 41, 24 and 12 months, respectively. The model provided similar results to those of the British Medical Research Council, whereas the staging systems proposed by Durie and Salmon, Merlin et al. and Carbone et al. had a lower discriminant value in our series.
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PMID:Prognostic factors and classification in multiple myeloma. 275 17

Haematological and biochemical investigations were performed on 14 koalas with uncomplicated cystitis, 8 with complicated cystitis, 8 with conjunctivitis, 8 with lymphosarcoma, and 14 with miscellaneous diseases. Changes were limited and inconsistent in individual koalas with uncomplicated cystitis and conjunctivitis. In contrast, individual koalas with complicated cystitis were more likely to have anaemia, leukocytosis due to neutrophilia, hypoproteinaemia due to hypoalbuminaemia, and azotaemia due to elevated urea concentration. Although these changes were non-specific they did allow assessment of prognosis for survival and response to treatment. Koalas with lymphosarcoma were invariably anaemic, leukaemic, azotaemic and hypoalbuminaemic. Elevated enzymes (aspartate transaminase [AST]. lactate dehydrogenase [LD] and gamma glutamyl transferase [GGT]) were more common in koalas with lymphosarcoma. Koalas affected by miscellaneous conditions showed variable changes but once again anaemia, leukocytosis, azotaemia, elevated AST and LD, and hypoalbuminaemia were not uncommon. On the basis of these findings a minimal profile is suggested for the investigation of sick koalas and would include haematocrit, total and differential leukocyte counts, urea, total protein and albumin concentrations and AST, GGT and LD activities.
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PMID:Haematological and biochemical investigations of diseased koalas (Phascolarctos cinereus). 281 69

The progression of effects induced by administration of ochratoxin A were characterized in young male broiler chickens (Hubbard x Hubbard). The experimental design consisted of four dietary treatments of ochratoxin A (0, 1.0, 2.0, and 4.0 micrograms ochratoxin A/g feed) and 11 replicates of 10 broilers/replicate. Broilers were housed in electrically heated batteries with feed and water available ad libitum. Broilers were weighed, bled, killed by cervical dislocation, and necropsied at 3, 6, 9, 12, 15, 18, and 21 days of age. Toxicity of ochratoxin A to broilers was evident as early as 6 days of age, when significant (P less than .05) growth depression occurred at 4.0 micrograms dietary ochratoxin A/g feed. Dietary ochratoxin A significantly increased the relative weights of the liver, kidney, spleen, pancreas, and gizzard. Anemia, characterized by a significant decrease in packed-cell volume and hemoglobin levels, was present during ochratoxicosis. Hepatotoxicity of dietary ochratoxin A was evident through an observed significant reduction in serum levels of total protein, albumin, globulin, cholesterol, triglyceride, and blood urea nitrogen, and a significant increase in the serum activities of gamma glutamyl transferase and cholinesterase. A significant increase in serum uric acid and creatinine levels was indicative of nephrotoxicity. These data provide a description of the progression of ochratoxicosis in broilers that should be useful in diagnosis and in improved understanding of ochratoxicosis.
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PMID:Progression of ochratoxicosis in broiler chickens. 290 99


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