Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0035078 (renal failure)
 31,970 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Although erythropoietin (Epo) is known to correct anaemia in dialysis and pre-dialysis patients, there is limited experience with its use in immunosuppressed patients suffering from chronic renal graft dysfunction. We report the results of a pilot study of Epo in seven patients with failing grafts and normocytic normochromic anaemia attributable to renal failure. All entering patients had controlled blood pressure and serum ferritin greater than 100 micrograms/l. Three patients were taking triple immunotherapy (prednisone/azathioprine/cyclosporin), two patients prednisone/azathioprine, and two patients CsA monotherapy. Study duration mean was 15 +/- 2 (SEM) weeks, and Epo was started at 4000 units subcutaneously (s.c.) once weekly, adjusted to achieve a target haemoglobin (Hb) of 100 g/l. Mean Hb at initiation was 68 +/- 5 g/l and significantly increased to 96 +/- 6 at end of follow-up, P less than 10(-4). All patients responded. Maintenance Epo dosage was 120 +/- 32 U/kg bodyweight/week, roughly 4000 units/week. There was no significant change in serum creatinine: pre-study 392 +/- 45 mumol/l; post-study 430 +/- 62 mumol/l. There were no complications but blood pressure did rise significantly: pre- 124 +/- 11/74 +/- 4 mmHg to post- 142 +/- 10/86 +/- 3, P less than 0.05 for systolic and diastolic. Low-dose s.c. Epo effectively corrects anaemia in graft failure despite azathioprine and/or CsA therapy, without obvious acceleration of graft failure.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Low-dose subcutaneous erythropoietin corrects the anaemia of renal transplant failure. 131 75

It has been 6 years since the first reports of the use of recombinant human erythropoietin for the treatment of renal anemia appeared in the medical literature. During this period, erythropoietin has become established as a safe and highly effective therapy, and it is currently being evaluated for other nonrenal types of anemia. The initial clinical trials were in hemodialysis patients, followed by patients receiving continuous ambulatory peritoneal dialysis, and its use in predialysis and renal transplant patients is increasing. Various treatment schedules have been tried and compared; there are now reports of dosage frequencies varying from once daily to once weekly. Information has accumulated on the secondary effects of correction of renal anemia, particularly in relation to quality of life, exercise capacity, and cardiac function. Large multicenter trials have documented the safety profile of erythropoietin, whereas smaller studies have sought to elucidate the pathophysiology of its side effects, eg, hypertension and thrombotic events. This article reviews the latest developments in the use of erythropoietin in renal failure, concentrating particularly on those that have been published within the past year. Although there have been exciting advances in our understanding of the physiology and molecular biology of erythropoietin, these are amply described elsewhere and are beyond the scope of the present review.
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PMID:Treatment of renal anemia with recombinant human erythropoietin. 134 20

The erythropoietic response to graded doses of recombinant human erythropoietin (epoetin alfa) was assessed in 24 hemodialysis patients by quantitative ferrokinetic studies, and measurement of the reticulocyte count and plasma levels of transferrin receptor protein. These responses were compared to those of 22 normal subjects. Epoetin alfa was given intravenously at 15, 50 or 150 U/kg every other day for four injections. Three patients with chronic renal failure were restudied after renal function was restored following renal transplantation. The results of these three different measurements of erythroid function showed that the acute response to recombinant human erythropoietin was similar in normal subjects and patients with renal failure. We conclude that chronic uremia does not alter the responsiveness to erythropoietin in vivo.
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PMID:A comparison of the responses to recombinant human erythropoietin in normal and uremic subjects. 140 23

Hypoproliferative anemia is a predictable and serious complication of progressive renal failure and contributes significantly to the overall morbidity of the uremic state. Until recently, there has been no satisfactory therapy to resolve the anemia. Now the anemia can be explicitly corrected with erythropoietin-replacement therapy, and the clinical debility generally attributable to renal insufficiency can be lessened and retarded. Anemia must no longer be regarded as an intractable consequence of the uremic syndrome and should be managed as conscientiously as the other polysystemic features of uremia.
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PMID:Pathophysiology and management of anemia in chronic progressive renal failure. 141 Aug 49

The influence of recombinant human erythropoietin (rHu-EPO) on anaemia and bone marrow cells was investigated in 7 patients with terminal renal failure on maintenance haemodialysis. The examination was performed immediately prior to rHu-EPO treatment (mean hematocrit 20.3%) and after increase of hematocrit to 33%. An increased number of cells from the erythroblastic series and rejuvenation of this population were observed during the treatment. There was no significant influence of the treatment on the myeloblastic cells series. An increase in megakaryocyte activity was observed in 2 studied patients.
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PMID:[Effect of recombinant human erythropoietin on the bone marrow picture in patients with chronic renal failure treated by hemodialysis]. 143 2

Symptomatic anemia is a common complication of chronic renal failure. Treatment is now possible with the availability of recombinant human erythropoietin (epoetin alfa). Previous experimental studies have suggested that correcting the anemia of chronic renal failure may be harmful in that renal failure may be accelerated. Although experience with this drug has been primarily restricted to its use in patients with end-stage renal disease, several recent trials have been reported in patients with varying degrees of chronic renal failure. We review these studies with particular reference to the progression of renal failure and the drug's reported side effects. We conclude that the use of epoetin is beneficial and well tolerated and that there is no compelling evidence for the acceleration of renal failure associated with its use in patients.
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PMID:Erythropoietin therapy in patients with chronic renal failure. 144 90

Erythropoietin was applied subcutaneously to 49 patients, 41 have been treated by hemodialysis, 3 by continuous ambulatory peritoneal-dialysis, 5 had chronic progressive renal failure. Mean initial dose of erythropoietin was 139.4 U/kg/week and maintenance dose 115.9 U/kg/week. In 43% of patients serum ferritin was decreasing during treatment, and in 20% it was low before the commencing of the treatment. During erythropoietin therapy vitamin B12 was decreasing in 22% of the patients, and the substitution was necessary in 18%. Only in 1 patient it was necessary to substitute also folic acid. There were no nonresponders among erythropoietin treated patients. Elevation of blood pressure was observed in half of the patients, hypertensive encephalopathy in 1, and thrombosis of arterio-venous fistula in 3.
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PMID:Subcutaneous erythropoietin in the treatment of renal anaemia. 145 4

The effect of recombinant human erythropoietin (rHu-EPO) on anaemia and some biochemical parameters was investigated in 7 predialysis patients. A statistically significant increase in erythrocyte, haematocrit and haemoglobin levels was observed after 3 weeks of treatment and such changes were constant during the 6 month maintenance therapy. The mean urea and creatinine levels were comparable during the tested period in 4 of the studied patients. The other 3 patients did not completed the planed period and started the dialytic therapy because of progression of renal insufficiency. The latter group had more advanced renal failure and higher blood pressure prior to rHu-EPO treatment as compared with the patients who completed the study.
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PMID:[Effect of recombinant human erythropoietin (rHu-EPO) on anemia and selected biochemical parameters in patients in the pre-dialysis period]. 145 7

Recombinant human erythropoietin (EPO) was administered to 12 children with terminal renal failure aged 8-17 years subjected to hemodialysis for a mean period of 16 (S.D. = 19.7) month prior to EPO utilisation. The hormone was administered thrice weekly at an intravenous dose of 25-75 u/kg until Hb value of 100 g/l was obtained, and subsequently at maintenance doses for mean period of 7 (S.D. = 4.0) month. The urea kinetic modeling (UKM) algorithms allowed to compute protein catabolic rate (pcr) for each patient in modeling sessions performed once a month. The analysis included the effect of EPO upon: 1. peripheral whole blood count; 2. individual UKM parameters; 3. selected lab data describing the metabolic status of the patient (predialysis potassium, phosphorus, creatinine, total blood protein and albumin--and iron levels), in three randomized groups according to the value of pcr. Group I presented pcr less than 1.0 g protein/kg/day typical for malnutrition; group II--pcr = 1.0-1.4 g protein/kg/day--with appropriate protein catabolism; group III--pcr greater than 1.4 g protein/kg/day--hypercatabolic. The results from 188 pre-EPO modeling sessions and 78 sessions in the course of EPO treatment were compared. All the three groups revealed statistically significant increased Hb, Ht and erythrocyte count after EPO administration, which also resulted an increase of protein catabolism what is manifested in a decrease in the number of sessions by 26.1% in Group I and a corresponding increase by 13.5% and 12.6% in Groups II and III, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Effect of recombinant human erythropoietin--rHu-EPO on the metabolism of children treated by long-term hemodialysis]. 145 8

The effects of recombinant human erythropoietin (rHuEPO) on mean arterial pressure (MAP) and renal hemodynamics were studied in anesthetized rabbits without renal failure. Intrarenal infusion of rHuEPO at a rate of 100 U/min for 30 min resulted in no change in MAP, renal blood flow, or renal vascular resistance. rHuEPO also produced no significant change in glomerular filtration rate filtration fraction, or arterial hematocrit. These results demonstrate that rHuEPO has no direct effects on MAP or renal hemodynamics in anesthetized rabbits without renal failure.
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PMID:The effects of intrarenal infusion of recombinant human erythropoietin on mean arterial pressure and renal hemodynamics in anesthetized rabbits. 145 17


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