Abstract:
:While patients with sickle cell disease currently constitute a very small minority of the US dialysis population (0.1%), there is anticipated growth of this group as the life expectancy of those with sickle cell disease (SCD) increases. SCD patients suffer a high burden of morbidity, which is enhanced by the presence of end-stage renal disease (ESRD). In this review, we discuss the pathophysiology of SCD and the basic tenets of its management with focus on the dialysis patient with SCD. Anemia in dialysis patients with SCD is a unique challenge. The hemoglobin target in SCD dialysis patients with ESRD should not exceed 10 g/dl. SCD patients, and particularly those on dialysis, are likely to be poorly responsive to erythropoietin-stimulating agent (ESA) therapy and might be at increased risk for vaso-occlusive crisis (VOC) with ESA. Iron chelation and hydroyxurea therapy require special considerations and modifications in dialysis patients with SCD. There are theoretical advantages to both hemodialysis (HD) and peritoneal dialysis (PD) in SCD patients. With HD, there is a secure vascular access available for both standard and exchange blood transfusion in patients who need them. With PD, the absence of an acute rise in hematocrit with ultrafiltration (UF) might offer lower risk of VOC. During VOC, reduction in UF goals should be considered but administration of intravenous fluids should be reserved only for clear cases of volume depletion. Finally, renal transplantation appears to confer a survival advantage to dialysis in SCD patients and should be pursued when possible.
journal_name
Semin Dialjournal_title
Seminars in dialysisauthors
Boyle SM,Jacobs B,Sayani FA,Hoffman Bdoi
10.1111/sdi.12403subject
Has Abstractpub_date
2016-01-01 00:00:00pages
62-70issue
1eissn
0894-0959issn
1525-139Xjournal_volume
29pub_type
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journal_title:Seminars in dialysis
pub_type: 杂志文章
doi:10.1111/j.1525-139X.2012.01112.x
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journal_title:Seminars in dialysis
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journal_title:Seminars in dialysis
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journal_title:Seminars in dialysis
pub_type: 杂志文章
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更新日期:2018-03-01 00:00:00
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journal_title:Seminars in dialysis
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journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
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更新日期:2013-07-01 00:00:00
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journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
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更新日期:2016-11-01 00:00:00
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journal_title:Seminars in dialysis
pub_type: 杂志文章
doi:10.1111/sdi.12904
更新日期:2020-07-23 00:00:00
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journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
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更新日期:2002-01-01 00:00:00
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journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
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更新日期:2011-09-01 00:00:00
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journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1046/j.1525-139x.2001.00109.x
更新日期:2001-11-01 00:00:00
abstract::Percutaneous peritoneal catheter insertion can be performed by trained nephrologists. The objective of this study was to compare the outcome of peritoneal dialysis (PD) catheters percutaneous inserted with the traditional surgical technique. One hundred twenty-one PD catheters were placed in 121 stage-5 Chronic kidney...
journal_title:Seminars in dialysis
pub_type: 杂志文章
doi:10.1111/sdi.12147
更新日期:2014-05-01 00:00:00
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journal_title:Seminars in dialysis
pub_type: 杂志文章
doi:10.1111/sdi.12015
更新日期:2012-11-01 00:00:00
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journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
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更新日期:2014-11-01 00:00:00
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journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/j.0894-0959.2004.17617.x
更新日期:2004-11-01 00:00:00
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journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/sdi.12706
更新日期:2018-07-01 00:00:00
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journal_title:Seminars in dialysis
pub_type: 社论
doi:10.1111/sdi.12483
更新日期:2016-09-01 00:00:00
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journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
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更新日期:2014-09-01 00:00:00
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journal_title:Seminars in dialysis
pub_type: 杂志文章
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更新日期:2020-11-01 00:00:00
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journal_title:Seminars in dialysis
pub_type: 社论,评审
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journal_title:Seminars in dialysis
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doi:10.1111/j.1525-139X.2008.00537.x
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journal_title:Seminars in dialysis
pub_type: 社论,评审
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journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/sdi.12815
更新日期:2019-07-01 00:00:00
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journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/j.1525-139X.2006.00212.x
更新日期:2006-11-01 00:00:00
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journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
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更新日期:2003-11-01 00:00:00
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pub_type: 杂志文章,评审
doi:10.1111/j.1525-139X.2005.18404.x
更新日期:2005-07-01 00:00:00
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journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1046/j.1525-139x.2001.00071.x
更新日期:2001-07-01 00:00:00
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journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/sdi.12937
更新日期:2020-12-09 00:00:00
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journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/sdi.12759
更新日期:2019-03-01 00:00:00
abstract::The majority of end-stage renal disease (ESRD) patients are hypertensive. Drug therapy for hypertension in hemodialysis (HD) patients includes all classes of antihypertensive drugs, with the sole exception of diuretics. Angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers may decrease mo...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
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更新日期:2004-07-01 00:00:00