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 human erythropoietin (EPO) was administered to 32 stable out-patients with end-stage renal disease (ESRD) on a priority basis three times a week. All patients underwent dialysis with polysulfone hollow fiber dialyzers. Mean time-averaged blood urea nitrogen (BUN) value was 50 +/- 12 mg/dl, and Kt/V for urea was 1.20 +/- 0.34/dialysis. The initial dose of EPO was 2,800 +/- 950 U/dialysis (45 +/- 17 U/kg/dialysis). The maintenance dose averaged 2,500 U/dialysis. Within the mean time of observation, 15 +/- 4 weeks, all but one patient responded to EPO by eliminating transfusion requirements, and 29 of 32 achieved the target hematocrit of 30-33%. For patients with hematocrits below 25% before EPO, the increase averaged 1.6 +/- 0.8%/week. The dose of EPO was lower and the hematocrit response was higher than reported previously. The rate of increase in hematocrit did not correlate with small molecular weight solute removal. Mean red blood cell survival was 52 +/- 18 days. No adjustments in blood pressure (BP) medications or dry weight were required to control BP. These data and earlier experiences with recovery from the anemia of ESRD after more effective dialysis suggest that the bone marrow response to EPO may be augmented by high flux hemodialysis.
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PMID:Effectiveness of low dose erythropoietin: a possible advantage of high flux hemodialysis. 225 62

Recombinant human erythropoietin (r-HuEPO) was given to 51 maintenance hemodialysis patients in an attempt to correct the anemia of uremia. A subset of eight randomly chosen stable patients (four men and four women, mean age 42.3 years) had in vivo urea and creatinine dialyzer clearances measured before and after their hematocrits were increased by r-HuEPO treatment. The same dialyzer was used in both the pre-r-HuEPO and post-r-HuEPO studies. Dialyzer creatinine (Ccr) and urea (Ucr) clearances were measured at a blood flow of 300 ml/min 1 hour after the initiation of dialysis. The mean hematocrit of the group of 51 patients increased from 19% (range, 14-28%) to 33% (range, 21-27%). The mean hematocrit of the eight patients in whom the clearance studies were done was 19% before r-HuEPO and 35% after. Mean creatinine and urea clearances for the eight subjects at the lower hematocrit were 143 and 190 ml/min, respectively. After the increase in hematocrit, the mean creatinine and urea clearances were slightly lower at 132 and 166 ml/min, respectively. No patient had a rise in predialysis serum potassium, creatinine, or blood urea nitrogen. The authors concluded that the magnitude of changes in creatinine and urea clearances secondary to a r-HuEPO stimulated rise in hematocrit will be small and will not necessitate increases in dialysis time.
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PMID:Dialyzer urea and creatinine clearances are not significantly altered in erythropoietin treated maintenance hemodialysis patients. 230 89

Recombinant human erythropoietin (rHuEPO) was purified from the conditioned media of Chinese hamster ovary cells with a transfected human erythropoietin gene. We investigated the effects of the rHuEPO in rats with renal anemia induced by partial nephrectomy. Five-sixth nephrectomy resulted in renal failure with anemia. Twenty-five days after the operation plasma urea nitrogen was increased about 2.5 times, and the red blood cell count, hematocrit, and hemoglobin concentration fell to 85% of normal. The reticulocyte count and plasma erythropoietin level did not change such as they do in patients with anemia due to chronic renal failure. Both total red blood cell volume and the plasma iron turnover rate were depressed in five-sixth nephrectomized rats compared with normal rats. The five-sixth nephrectomized rats were injected with rHuEPO (60 IU/kg) intravenously every second day for a total of six injections. After three injections of rHuEPO, circulation volume of total red blood cells was increased from 9.9 ml to 14.6 ml, and the plasma iron turnover rate was increased from 1.03 mg/kg/day to 2.12 mg/kg/day, and the reticulocyte count was also increased. After six injections, a marked increase of the red blood cell count, hematocrit, and hemoglobin concentration were observed. Plasma urea nitrogen and the creatinine levels as indications for renal function did not change after rHuEPO administration in both normal and five-sixth nephrectomized rats. In conclusion rHuEPO has a potent erythropoietic action and it is possible to cure the anemia caused by renal failure.
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PMID:Effect of purified recombinant human erythropoietin on anemia in rats with experimental renal failure induced by five-sixth nephrectomy. 240 Jun 29

Withholding iron dextran treatment normally given to pigs at 1-3 days of age to prevent anemia resulted also in neutropenia. Polyinosinic acid:polycytidylic acid (poly I:C) at 0.5 mg/kg IV at 25 days of age resulted in induction of putative interferon 2 to 24 hours later, with significantly (P less than 0.05) lower concentrations in iron-deficient (Fe-) female pigs than in iron-supplemented (Fe+) female pigs. Poly I:C caused several transient toxic manifestations, including elevations in blood urea nitrogen, creatinine, aspartate aminotransferase, potassium (K), total bilirubin and phosphorus (P), marked leukopenia (both neutropenia and lymphopenia), and declines in serum albumin, calcium, cholesterol, glucose and globulin. Certain blood chemistries before poly I:C were significantly (P less than or equal to 0.05) different: albumin, globulin, cholesterol and K were higher in females than in males; albumin, globulin, glucose, P and K were higher in Fe- than in Fe+ pigs; and total carbon dioxide was higher in Fe+ than in Fe- pigs.
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PMID:Effects of poly I:C in porcine iron deficient neutropenia. 241 Jan 86

Toxic side effects of germanium dioxide contained in drugs that promote health, include nephropathy, anemia and peripheral neuropathy. Although the neuropathy, which we are interested in, is believed to occur in the patients taking excessive amounts of germanium dioxide, the pathogenesis of such neuropathy is not well understood. Therefore, we studied whether germanium dioxide causes the degeneration of the peripheral nerve in rats and monkeys. Our results showed that in rats, germanium dioxide administered orally and intraperitoneally, 100 mg/kg per day, 3 days a week for 8 weeks and 400 mg/kg per day, once a week for 8 weeks, respectively, did not produce a degeneration of myelinated fibers in teased fiber preparations and Epon-embedded sections of the peripheral nerve. In two monkeys also, germanium dioxide, administered orally, 30 to 40 mg/kg per day, 5 days a week for 8 months, did not produce a degeneration of myelinated fibers of the sural nerve on biopsy, although our results revealed proteinuria and elevated blood urea nitrogen. Further studies are warranted to elucidate the pathogenesis of germanium dioxide induced neuropathy.
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PMID:[Evaluation of germanium dioxide neurotoxicity in rats and monkeys]. 251 Feb 28

Echocardiography was studied in 83 uremic patients on maintenance hemodialysis and 18 normal subjects. Cardiac systolic and diastolic functions were evaluated according to Yamaguchi's method. Systolic functions such as ejection fraction and fractional shortening decreased in the patients receiving hemodialysis for less than 3 months. However, they remained within normal range in the patients under hemodialysis for more than 3 months. There were no significant correlations between systolic functions and mean blood pressure or various serum biochemical parameters such as urea nitrogen, creatinine, Na, K, Ca, P, hematocrit and PTH-C. Diastolic functions such as rapid filling rate/endosystolic volume, mean velocity of circumferential fiber lengthening during rapid filling, diastolic descent rate and diastolic posterior wall velocity also decreased in the patients receiving hemodialysis for less than 3 months. However, they increased slightly in the patients under hemodialysis for more than 3 months, although they were still lower than those in normal subjects. They were not related to mean blood pressure or various serum biochemical parameters. Hemodialysis patients had left ventricular hypertrophy regardless of duration of hemodialysis. Diastolic dysfunction in hemodialysis patients seemed to be due to systolic dysfunction, left ventricular hypertrophy and diminished ventricular compliance with myocardial degeneration. It was also suggested that increasing slow filling and atrial contraction in diastole might be related to diastolic dysfunction. These cardiac changes may be compensatory reactions of cardiac muscle to various uremic environments such as anemia, hypertension, fluid retention, electrolytes disturbance or uremic toxins.
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PMID:[An echocardiographic study of cardiac function in chronic hemodialysis patients]. 258 30

An 8-year-old sexually intact male llama was euthanatized because of obstruction of the penile portion of the urethra and rupture of the urinary bladder. Clinical signs of obstruction included anorexia, lethargy, teeth grinding, straining to defecate, inability to urinate, and tense abdomen. Laboratory findings included anemia, leukocytosis with left shift, high serum urea nitrogen, creatinine, and phosphorus concentrations, and low serum chloride concentration. Necropsy revealed ruptured urinary bladder and acute fibrinous peritonitis. A firm, gray, nonmineralized urethral plug occluded the penile portion of the urethra for a distance of 14 cm in the midpenile region, distal to the sigmoid flexure of the penis. The urinary bladder mucosa and the urethra had microscopic evidence of chronic inflammation. Escherichia coli, Klebsiella sp, and alpha-streptococci were isolated from the urethral plug.
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PMID:Urethral obstruction in a male llama. 259 47

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

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

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


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