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Query: UMLS:C0018801 (heart failure)
 72,216 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Renal anaemia is an independent risk factor for the development of left ventricular hypertrophy (LVH), heart failure and mortality. Studies show that partial correction of anaemia leads to partial regression of LVH. However, early initiation of anaemia therapy may be the optimal way to reduce cardiac morbidity and mortality. The Cardiovascular risk Reduction by Early Anemia Treatment with Epoetin Beta (CREATE) trial will investigate the effect of early anaemia correction on cardiovascular risk reduction in patients not yet on renal replacement therapy. The primary objectives of this open, randomized, multicentre trial are to investigate the effect of early anaemia correction on the change in left ventricular mass index after 1 year, and the time to first cardiovascular event. The trial comprises two treatment arms: early intervention where patients will receive epoetin beta when their haemoglobin (Hb) level is 11-12.5 g/dl and their target Hb will be 13-15 g/dl, and late intervention, where patients will receive epoetin beta once their Hb level is <10.5 g/dl and their target Hb will be 10.5-11.5 g/dl. The study will be event-driven with a continuous evaluation and an interim analysis once every year. The inclusion of 600 patients is based on assumption of a 15-20% event rate in the control group and that 200 events are needed to detect a reduction of about one-third. In conclusion, the CREATE trial will examine whether early anaemia treatment will prevent development of LVH, reduce cardiovascular morbidity and provide other benefits.
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PMID:The CREATE trial--building the evidence. 1136 44

Renal anemia is a well-recognized complication of chronic kidney disease (CKD), and the deficiency of erythropoietin (EPO) is the primary cause. Observational population-based studies continue to demonstrate the association of low hemoglobin with adverse outcomes, and renal failure, cardiac failure, and anemia all may interact to cause or worsen each other, the so-called cardio-renal anemia syndrome. Treatment of anemia can be successfully achieved with the use of erythropoiesis-stimulating agents (ESAs). From a mechanistic point of view, however, the therapeutic benefits of ESA could be far beyond the correction of anemia. ESA modulates a broad array of cellular processes that include progenitor stem cell development, cellular integrity, and angiogenesis. A pleiotropic effect of EPO has been shown in the central nervous system, the cardiovascular system, and the kidney. While recent results of randomized controlled trials have established that there is little support for normalizing hemoglobin in CKD patients, the results of these studies do not negate renoprotective effects of EPO. A large number of patients with CKD will benefit from early recognition and appropriate correction of anemia with ESA.
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PMID:Erythropoiesis-stimulating agents: past and future. 1794 37

Anemia is the most frequent haematological problem of chronic kidney disease (CKD). It begins in early stage of CKD and worsens with disease progression, affecting nearly all of predialysis patients. It is usually asymptomatic, therefore is underdiagnosed and undertreated. Anemia of CKD is predominantly a result of abnormal erythropoietin (EPO) production and iron deficiency. Renal anemia is associated with an increased risk of ischemic heart disease, left ventricular hypertrophy, chronic heart failure and higher cardiovascular morbidity and mortality. Patients et risk for CKD should be more often monitored for early detection of anemia so they could start with treatment on time. Recent studies show that erythropoeisis-stimulating agents (ESAs) are effective in predialysis especially if used with antihypertensive agents and statin. Correcting anemia in early stage kidney disease may delay progression to end-stage kidney disease (ESRD) and prolong time to start dialysis. Improved cardiac function in those patients reduce morbidity and mortality risk and improve quality of life (QoL) in patients with CKD.
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PMID:[Treatment anaemia of chronic kidney disease in predialysis patients (stage 1-4)]. 2023 47

Renal anemia is a well-recognized complication of chronic kidney disease (CKD). The primary cause is the deficiency of erythropoietin (EPO). There is an evident association between low hemoglobin with adverse outcomes of CKD patients. Many morbidity conditions observed in CKD patients are cardiovascular complications including left ventricular hypertrophy, ischemic heart disease, chronic heart failure, generalized atherosclerosis, and stroke. It is suggested that renal anemia, chronic renal failure, and chronic heart failure all interact to cause or worsen each other (anemia-renalcardio syndrome). Treatment of renal anemia may be successfully achieved with the use of erythropoesis-stumulating agents (ESAs), but the therapeutic benefits of ESA could be far beyond the correction of anemia. ESA can protect organs via hematopoiesis-dependent and -indemendent manner. A pleiotropic affect of EPO has been shown in the kidney, the central nervous system, and the cardiovacular system. Alarge number of CKD patients will benefit from early recognition and appropriate correction of renal anemia with ESA. Research during the past years has clearly demostrated that the administration of ESA reduced brain injury associated with stroke, blunt trauma, cytotoksicity, and prevented spinal cord injury. The correcting of anemia with ESA in patients suffering from congestive heart failure caused an improvement in cardiac function. The renal function may be improved, at least, in selected subjects, by the ESA treatment of anemia.
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PMID:[Erythropoesis-stimulating agents: past, present and future]. 2023 51