scholarly journals Erythropoietin therapy in predialysis patients

2003 ◽  
Vol 56 (11-12) ◽  
pp. 529-535 ◽  
Author(s):  
Nada Dimkovic
Keyword(s):  
Renal Failure ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Hemoglobin Concentration ◽  
Cardiovascular Morbidity ◽  
Morbidity And Mortality ◽  
Cardiovascular Morbidity And Mortality ◽  
Progression Of Renal Failure ◽  
Stage Renal Disease ◽  
End Stage

Introduction Anemia is recognized as a very important non-traditional risk factor for cardiovascular morbidity and mortality in patients with uremia. Despite many advantages of erythropoietin therapy, the number of patients treated with this drug is modest, particularly during the pre-end stage renal disease. Patients with chronic renal failure are at risk to develop coronary artery disease, left ventricular hypertrophy and chronic heart failure when hemoglobin concentration falls below 10 g/dl and creatinine clearance under 60 ml/min. Erythropoietin therapy Early erythropoietin treatment prevents not only cardiovascular morbidity and mortality, but also progression of renal failure towards end-stage renal disease. Anti-oxidant, anti-hypoxic and anti-apoptotic effects of erythropoietin prevent tubular lesions and interstitial fibrosis. There still remains a confusion regarding the optimum target hemoglobin concentration in the pre-dialysis phase. Guidelines in Europe and US are probably not appropriate for all patients and it is important that renal anemia patients are considered as individuals. It may be appropriate to normalize hemoglobin concentration in young patients who have active lifestyles and no severe co-morbidity. In contrast, partial correction is more appropriate for the elderly with significant co-morbidities. Special attention should be paid to patients with diabetes, where anemia starts earlier and is more profound than in other renal patients. There is no risk of early anemia treatment using erythropoietin and this regime does not increase the total cost of treatment. Conclusion Early referral to a nephrologist is the key how to define underlying renal disease, slow down the progression of renal failure, prevent co-morbid conditions and to prepare patients for end-stage renal disease treatment.

P97 An uncommon reason of end stage renal disease: 3 cases with joubert syndrome and renal failure

2017 ◽  
Author(s):  
Aysun Karabay Bayazit ◽  
Bahriye Atmiş ◽  
Engin Melek ◽  
Abdulsamet Ala ◽  
Merve Sapmaz ◽  
...  
Keyword(s):  
Renal Failure ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Joubert Syndrome ◽  
Stage Renal Disease ◽  
End Stage

scholarly journals Acute Intradialytic Complications in End Stage Renal Disease on Maintenance Hemodialysis

2012 ◽  
Vol 52 (187) ◽  
Author(s):  
R K Agrawal ◽  
S Khakurel ◽  
R Hada ◽  
D Shrestha ◽  
A Baral
Keyword(s):  
Renal Failure ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Maintenance Hemodialysis ◽  
Care Hospital ◽  
Cross Sectional ◽  
Stage Renal Disease ◽  
End Stage

Introduction: Hemodialysis is the preferred method of treatment for Nepalese patients with End Stage Renal Disease. Despite the technological advances and better understanding of physiology associated with hemodialysis, a number of complications are known to be associated with hemodialysis. This study was undertaken to study the frequency of acute intradialytic complications in patients undergoing hemodialysis. Methods: A cross-sectional study was conducted at Nephrology unit of a tertiary care hospital from 15 June, 2007 to 15 December, 2007. A total of 28 patients were included in the study. Patients with acute renal failure and acute on chronic renal failure were excluded from the study. Results: Total sessions of hemodialysis during the period were 1455. Hypotensive episode were 66 (4.5%) and was the commonest complication and followed by hypertensive episodes were 58 (3.8%). Other problems encountered were transfusion reactions were 23 episodes (1.5%), rigors not related to transfusions were 13 episodes (0.8%), nausea/vomiting were 20 episodes (1.4%), muscle cramps were 12 episodes (0.8%), hypoglycemia were 6 episodes 5(0.4%). Conclusions: The frequency of intradialytic complications is low and many of them are not life threatening. Keywords: complications; end stage renal disease; hemodialysis; hypertension; hypotension.

Recent Advances in the Management of the Infant, Child, and Adolescent With Chronic Renal Failure

1990 ◽  
Vol 11 (9) ◽  
pp. 277-282
Author(s):  
Richard N. Fine
Keyword(s):  
Renal Failure ◽  
Chronic Renal Failure ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Quarter Century ◽  
Irreversible Reduction ◽  
Age Limits ◽  
Stage Renal Disease ◽  
End Stage

The prognosis of the infant, child, or adolescent with chronic renal failure, defined as an irreversible reduction in glomerular filtration rate, has improved during the past quarter century because of the use of dialysis and renal transplantation. These have prolonged lives in previously fatal situations. Because the potential not only to sustain life but also to effect full rehabilitation exists with the introduction of these treatments, it is now imperative that the multisystem consequences of uremia be either minimized or totally avoided in the pediatric patient with chronic renal failure. The role of the pediatrician in managing the infant, child, or adolescent with chronic renal failure should be directed toward minimizing the potentially devastating consequences of uremia so that the patient is in optimal clinical condition when end stage renal disease occurs. INCIDENCE It is difficult to know the incidence and prevalence of chronic renal failure and end stage renal disease in children. Surveys in Europe and North America have been conducted to obtain precise information regarding these issues; not only have the definitions included in these surveys differed, but the upper and lower age limits defining pediatric patients have not been uniform. The available data suggest a prevalence of chronic renal failure of 18.5 per 1 million child population and an incidence of end stage renal disease of from 3 to 6 children per 1 million total population.

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