Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Patients on hemodialysis (HD) are prone to atherosclerotic cardiovascular complications. In an attempt to determine the significance of several atherosclerotic and thrombogenic parameters as risk factors for atherothrombotic cardiovascular disease (CVD) in these patients, we compared two groups of non-diabetic HD patients matched for age and sex, selected according to the absence (group 1, n = 30) or presence (group 2, n = 30) of symptomatic atherothrombotic vascular disease affecting the coronary, cerebral, or peripheral arteries. Duration of HD, primary renal disease (PRD), presence of hypertension, EPO treatment, and smoking habits were recorded. Serum total cholesterol (TC), triglycerides (TG), HDL-C, LDL-C, TC/HDL-C ratio, lipoprotein(a) (Lp(a)), fibrinogen (FG), plasminogen (PLG), fibronectin (FN), and hematocrit (HCT) were measured pre-HD in a midweek session. The same blood parameters were also assessed in twenty matched clinically healthy subjects (controls). None of the blood parameters differed between groups 1 and 2, except for serum Lp(a) and FN, which were higher in group 2 (p = 0.005 and p = 0.041, respectively). Both groups were not different regarding PRD, duration of HD, and EPO treatment, but the presence of hypertension and smoking habits were more common in group 2 (p = 0.008 and p = 0.045, respectively). Moreover, multiple stepwise logistic regression analysis with Lp(a), FN, hypertension, and smoking showed that the presence of hypertension (p = 0.016) and the Lp(a) (p = 0.027) and FN (p = 0.024) levels, but not smoking, were independent predictors for the presence of atherothrombotic CVD. Our results suggest that hypertension, abnormal lipid particles, and thrombogenic proteins may contribute to the high prevalence of CVD in HD patients.
 ...
PMID:Cardiovascular risk factors in non-diabetic hemodialysis patients: a comparative study. 1921 4

The glycoprotein hormone erythropoietin is an essential viability and frowth factor for the erythrocytic progenitors. EPO signaling involves tyrosine phosphorylation of the homodimeric EPO receptor and subsequent activation on intracellular proteins, kinases and transcription factors. Treatment with recombinant human EPO(rHu EPO) is efficient and safe in improving the management of the anemia associated with chronic kidney disease, and allowing avoidance of transfusions with blood products. however, the unanticipated increase in mortality found in recent randomized studies is prompting a reassessment of this view. The present review will show what is known about the physiology of this plasma factor that, it is now clear, is more than just an erythrocyte production factor, and its pleitropic effects influencing the incidence of malignancy, thrombosis, hypertension and retinopathy.
 ...
PMID:[The clinical impact of the physiological effects of erythropoietin and erythropoietin-stimulating agents on the incidence of malignancy, and hypertension: beyond anaemia]. 1966 98

Recombinant human erythropoietin (rHuEPO) has been successfully and safely used to treat anemia in patients with end stage renal disease (ESRD). The safety profile of rHuEPO had been considered to be excellent with possible exception of hypertension and increased risk of dialysis access thrombosis. Recently, antibody-mediated pure red cell aplasia associated with administration of rHuEPO has been identified as a cause of major concern; we aimed to detect and evaluate the presence of anti-EPO antibodies in patients with ESRD on regular dialysis who are using rHuEPO. Serum anti-EPO antibodies were detected by enzyme-linked immunosorbant assay technique in a total of 90 patients who are currently on regular hemodialysis and using rHuEPO alpha subcutaneously for more than 6 months. All patients were subjected to full history taking and clinical examination. Complete blood count, reticulocytes count, serum creatinine, blood urea, serum albumin, serum ferritin, and hepatitis markers were performed for all patients. Our results showed that 35 patients (38.9%) had the anti-EPO antibodies in their blood, while 55 patients (61.1%) did not have the circulating antibodies. The mean hemoglobin (Hb) level was significantly lower in the antibody positive group (8.8 g/dl +/- 1.35) than in the antibody negative group (9.42 g/dl +/- 1.32) (P = 0.000). The reticulocytes count was also significantly much lower in the patients who had anti-EPO antibodies with mean of (1.99 +/- 1.14) vs. (3.15 +/- 0.89) in the antibody negative (P = 0.000). The dose of EPO administrated in both studied groups was insignificantly different. The incidence of anti-EPO antibodies is high in ESRD patients on maintenance hemodialysis. Its presence is associated with increased incidence of anemia possibly due to immune-mediated inhibition of erythropoiesis as evidenced by reticulocytopenia.
 ...
PMID:Detection of circulating antierythropoietin antibodies in patients with end stage renal disease on regular hemodialysis. 1970 35

Chronic kidney disease (CKD) is a widespread health problem in the world and anaemia of renal origin is a common problem. Anaemia associated with CKD covers significant risk for faster progression of chronic renal failure, decreased quality of life, and clinical manifestation of cardiovascular disease. The mainstay of anaemia treatment secondary to end-stage renal disease (ESRD) has become erythropoiesis stimulating agents (ESAs). More than 90 % of ESRD patients maintained on dialysis respond to traditional recombinant human erythropoietin (rHU EPO) or to EPO analogues, also called "biosimilars". Iron deficiency often co-exists in dialysis patients and must be evaluated and treated to reduce ESA requirements. Partial, but not complete correction of renal anaemia is associated with improved outcomes in patients with CKD. The use of ESAs does carry risks such as hypertension, pure red cell aplasia, or cancer, and these agents need to be used judiciously.
 ...
PMID:Erythropoiesis stimulating agents and anaemia of end-stage renal disease. 2044 66

Chronic kidney disease (CKD) is a risk factor for end-stage renal failure and cardiovascular events. In patients with CKD, anemia is often caused by decreased erythropoietin production relative to hemoglobin levels. As correction of anemia is associated with improved cardiac and renal function and quality of life, erythropoiesis-stimulating agents (ESAs) are standard therapy for anemia in CKD patients. However, traditional ESAs such as epoetin or darbepoetin have short half-lives and require frequent administration, dose changes, and close monitoring of hemoglobin concentration to maintain target hemoglobin levels. Methoxy polyethylene glycol-epoetin beta (MPG-EPO) is the only ESA that is generated by chemical modification of glycosylated erythropoietin through the integration of one specific, long, linear chain of polyethylene glycol. This ESA induces continuous erythropoietin receptor activation and has a long half-life (approximately 130 hours). Subcutaneous or intravenous administration of MPG-EPO once every 2 weeks or monthly achieved a high hemoglobin response rate in patients with anemia associated with CKD, regardless of whether the patient was undergoing dialysis. According to data from an observational time and motion study, MPG-EPO maintains hemoglobin levels when the same dose is administered, however infrequently. This suggests that compared with the use of traditional ESAs, administration of MPG-EPO reduces the overall time and cost associated with the management of anemia in CKD patients undergoing dialysis. MPG-EPO is generally well tolerated and most adverse events are of mild to moderate severity. The most commonly reported adverse effects are hypertension, nasopharyngitis, and diarrhea. Subcutaneous injection of MPG-EPO is significantly less painful than subcutaneous injection of darbepoetin. In conclusion, MPG-EPO is as effective and safe as traditional ESAs in managing renal anemia, irrespective of whether the patient is undergoing dialysis.
 ...
PMID:Methoxy polyethylene glycol-epoetin beta for anemia with chronic kidney disease. 2253 82


<< Previous 1 2 3 4