scholarly journals Artificial intelligence for optimal anemia management in end-stage renal disease

2016 ◽  
Vol 90 (2) ◽  
pp. 259-261 ◽  
Author(s):  
Michael E. Brier ◽  
Adam E. Gaweda
2018 ◽  
Vol 47 (5) ◽  
pp. 333-342 ◽  
Author(s):  
Carola-Ellen Kleine ◽  
Melissa Soohoo ◽  
Omesh N. Ranasinghe ◽  
Christina Park ◽  
Maria V. Marroquin ◽  
...  

Background: Incident hemodialysis patients have a high mortality risk within the first months after dialysis initiation. Pre-end-stage renal disease (ESRD) factors like anemia management may impact early post-ESRD outcomes. Therefore, we evaluated the impact of pre-ESRD hemoglobin (Hgb) and pre-ESRD Hgb slope on post-ESRD mortality and hospitalization outcomes. Methods: The study included 31,472 veterans transitioning to ESRD. Using Cox and negative binomial regression models, we evaluated the association of pre-ESRD Hgb and Hgb slope with 12-month post-ESRD all-cause and cardiovascular mortality and hospitalization rates using 4 levels of hierarchical multivariable adjustment, including erythropoietin use and kidney decline in slope models. Results: The cohort was 2% female, 30% African-American, and on average 68 ± 11 years old. Compared to Hgb 10–< 11 g/dL, both low (< 10 g/dL) and high (≥12 g/dL) levels were associated with higher all-cause mortality after full adjustment (HR 1.25 [95% CI 1.15–1.35] and 1.09 [95% CI 1.02–1.18], respectively). Similarly, Hgb exhibited a U-shaped association with CV mortality, while only lower Hgb was associated with a higher hospitalization rate. Neither an annual pre-ESRD decline in Hgb nor increase was associated with higher post-ESRD mortality risk after adjustment for kidney decline. However, we observed a modest J-shaped association between pre-ESRD Hgb slope and post-ESRD hospitalization rate. Conclusions: Lower and higher pre-ESRD Hgb levels are associated with a higher risk of early post-ESRD mortality, while there was no association between the pre-ESRD slope and mortality. An increase in pre-ESRD Hgb slope was associated with higher risk of post-ESRD hospitalization. Additional studies aimed at anemia management prior to ESRD transition are warranted.


2005 ◽  
Vol 63 (03) ◽  
pp. 202-208 ◽  
Author(s):  
D.I. Schwartz ◽  
A. Pierratos ◽  
R.M.A. Richardson ◽  
S.S.A. Fenton ◽  
C.T. Chan

2004 ◽  
Vol 27 (11) ◽  
pp. 1831-1833 ◽  
Author(s):  
Takeshi Kimura ◽  
Mamiko Arai ◽  
Hiroya Masuda ◽  
Atsufumi Kawabata

2010 ◽  
Vol 55 (4) ◽  
pp. B71
Author(s):  
Derek Larson ◽  
Junine DeGraf ◽  
Hongyan Du ◽  
Stacey Kirshenbaum ◽  
Stuart M. Sprague ◽  
...  

2020 ◽  
Vol 22 (2) ◽  
Author(s):  
Ly Minh Nguyen ◽  
Calvin J. Meaney ◽  
Gauri G. Rao ◽  
Mandip Panesar ◽  
Wojciech Krzyzanski

Author(s):  
Daisuke Fujimoto ◽  
Masataka Adachi ◽  
Yoshikazu Miyasato ◽  
Yusuke Hata ◽  
Hideki Inoue ◽  
...  

Abstract Background Serial management of renal anemia using continuous erythropoietin receptor activator (CERA) throughout the peritoneal dialysis initiation period has rarely been reported. We investigated the efficacy and dosage of CERA treatment from pre- to post-peritoneal dialysis initiation for anemia management in patients with end-stage renal disease. Methods Twenty-six patients (13 men; mean age 60.9 years) who started peritoneal dialysis between April 2012 and April 2018 were investigated. Serial changes in hemoglobin levels, transferrin saturation and ferritin levels, CERA dosage, and the erythropoietin resistance index (ERI) over a 48 week period were retrospectively examined. Results Mean hemoglobin levels increased significantly from 10.5 g/dL at 24 weeks prior to the peritoneal dialysis initiation to 11.5 g/dL at 4 weeks post-initiation. The proportion of patients with hemoglobin levels ≥ 11 g/dL increased significantly after peritoneal dialysis initiation. The mean CERA dosage was 57.0 µg/month at 24 weeks prior to dialysis initiation, 86.5 µg/month at initiation, and 72.0 µg/month at 4 weeks post-initiation. Thus, the dosage tended to increase immediately before peritoneal dialysis initiation and then decreased thereafter. Hemoglobin levels were significantly lower, while the CERA dosage for maintaining hemoglobin levels and ERI tended to be higher at dialysis initiation in patients with diabetes than in those without diabetes. Conclusion Treatment with CERA prior to and during the peritoneal dialysis initiation achieved fairly good anemia management in patients with and without diabetes. The CERA dosage could be reduced in patients without diabetes after dialysis initiation.


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