Abstract:
:Effective monitoring of chronic hemodialysis patients treated with recombinant human erythropoietin (r-HuEPO; EPOGEN [epoetin alfa], AMGEN Inc, Thousand Oaks, CA) includes an initial evaluation of the patient, the patient's anemia, and the patient's iron stores. Assessment of iron stores includes obtaining hematocrit and hemoglobin levels, reticulocyte count, red cell indices, serum ferritin level, transferrin percent saturation, and the patient's transfusion history. If iron stores are inadequate to support the increased erythropoiesis induced by the therapy, appropriate iron replacement therapy should be provided. Monitoring also involves assessment of BP (and its control), because development or exacerbation of hypertension is the most significant side effect associated with this treatment. Because the dose-response relationship for r-HuEPO therapy has been clearly documented, a target hematocrit and target rate of increase in hematocrit can be established. As anemia improves, continued monitoring of hematocrit, hemoglobin, red cell indices, serum ferritin level, and transferrin percent saturation will ensure that depleted iron stores are noted and treated as necessary. Heparin requirements during dialysis, blood chemistries, and blood access problems should also be monitored. No data currently exist suggesting that dialyzer reuse is compromised by r-HuEPO therapy. Quality-of-life surveys show improvement with r-HuEPO treatment and effective reduction of anemia. There is also some indication that morbidity is lessened and survival improved when anemia is treated with r-HuEPO therapy.
journal_name
Semin Nephroljournal_title
Seminars in nephrologyauthors
Ogden DAsubject
Has Abstractpub_date
1989-03-01 00:00:00pages
12-5issue
1 Suppl 2eissn
0270-9295issn
1558-4488journal_volume
9pub_type
杂志文章,评审abstract::Recent breakthroughs in genomics have led to a critical reappraisal of factors once thought to initiate common complex forms of kidney disease. The tenet that diabetes mellitus and hypertension routinely initiate kidney disease whenever blood glucose concentrations or systemic blood pressures reach critical levels for...
journal_title:Seminars in nephrology
pub_type: 杂志文章
doi:10.1016/j.semnephrol.2010.01.002
更新日期:2010-03-01 00:00:00
abstract::A complex pathophysiology, cardio-renal syndrome (CRS), has been redefined in recent years. One subtype is acute renocardiac CRS, or CRS type 3. This syndrome is intended to comprise situations in which acute kidney injury (AKI) results in acute cardiac injury or dysfunction. The pathophysiology of CRS type 3 is not w...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1016/j.semnephrol.2011.11.005
更新日期:2012-01-01 00:00:00
abstract::An expanding proportion of people in the United States and worldwide are affected by kidney disease, leading to a growing concern over the public health implications. Despite the high prevalence and the considerable associated health risks of kidney disease, major gaps in our knowledge base hinder the delivery of opti...
journal_title:Seminars in nephrology
pub_type: 评论,杂志文章,评审
doi:10.1016/j.semnephrol.2009.06.002
更新日期:2009-09-01 00:00:00
abstract::Cigarette smoking (CS) has been associated with augmented progression of nephropathies responsible for the 4 major causes of end-stage renal disease (ESRD) in the United States. CS has well-described ways by which it causes tissue injury in other organ systems and the mechanisms by which it adversely affects nephropat...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1016/s0270-9295(03)00037-8
更新日期:2003-05-01 00:00:00
abstract::Human immunodeficiency virus (HIV)-associated nephropathy (HIVAN), the single most common cause of end-stage renal failure in seropositive patients, has increased in incidence by 30% each year since 1991. Occurring almost exclusively in blacks, HIVAN became the third leading cause of ESRD in blacks, ages 20 to 64, in ...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:
更新日期:1998-07-01 00:00:00
abstract::One of the most important and lethal effects of animal venoms is nephrotoxicity. In Latin America, severe acute kidney injury has been reported after accidents with poisonous arthropods such as bees, caterpillars of the genus Lonomia, and spiders of the genus Loxosceles. In this article the characteristics of these ve...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1016/j.semnephrol.2008.04.006
更新日期:2008-07-01 00:00:00
abstract::Overweight and obesity are associated with arterial hypertension. Given the large increase in the obesity prevalence worldwide, the number of obese patients with hypertension is likely to increase substantially in the near future. Overweight and obese patients are exposed to an important metabolic and cardiovascular r...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1016/j.semnephrol.2007.07.009
更新日期:2007-09-01 00:00:00
abstract::Congenital anomalies of the kidney and urinary tract anatomy (CAKUT) are common in children and represent approximately 30% of all prenatally diagnosed malformations. CAKUT is phenotypically variable and can affect the kidney(s) alone and/or the lower urinary tract. The spectrum includes more common anomalies such as ...
journal_title:Seminars in nephrology
pub_type: 杂志文章
doi:10.1016/j.semnephrol.2010.06.004
更新日期:2010-07-01 00:00:00
abstract::Sonography has become integral to the evaluation and management of patients with renal disease. Although many of the procedures discussed in this issue are not feasible for all nephrologists, sonography clearly is. It is convenient and saves time, both for the physician and the patient, and the equipment is not expens...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1053/snep.2002.31712
更新日期:2002-05-01 00:00:00
abstract::The Kidney Early Evaluation Program (KEEP) is a free, community-based, kidney disease screening program designed to detect chronic kidney disease (CKD) early and promote follow-up evaluation with clinicians to ultimately improve outcomes. This program screens individuals with diabetes, hypertension, or those with a fi...
journal_title:Seminars in nephrology
pub_type: 杂志文章
doi:10.1016/j.semnephrol.2009.10.004
更新日期:2010-01-01 00:00:00
abstract::The antiphospholipid syndrome (APS) is a systemic autoimmune disorder characterized by a combination of arterial and/or venous thrombosis, pregnancy morbidity, and the persistent presence of circulating antiphospholipid antibodies (aPL). APS has been described as primary APS when it occurs in the absence of any featur...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1016/j.semnephrol.2015.08.009
更新日期:2015-09-01 00:00:00
abstract::Remarkable advances have been made in the past decade in understanding the pathophysiology of idiopathic nephrotic syndrome. Although the initiating events leading to the onset of proteinuria still are not well defined, it has become increasingly clear that many glomerular diseases can be classified as podocytopathies...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1016/j.semnephrol.2009.03.015
更新日期:2009-07-01 00:00:00
abstract::Premature menopause defined as secondary amenorrhea is common in women with kidney disease. Moreover, the aging population has resulted in increasing numbers of postmenopausal women with kidney disease. Though the pathophysiology is poorly understood, kidney transplantation and more frequent hemodialysis can restore m...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1016/j.semnephrol.2017.05.013
更新日期:2017-07-01 00:00:00
abstract::Amiloride is a prototypic inhibitor of epithelial sodium channels. Rapid progress has been made in our understanding of the structure of the sodium channel and related cation-selective channels. This work, coupled with experiments examining how selected sodium channel mutations affect amiloride binding, provides criti...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:
更新日期:1999-11-01 00:00:00
abstract::Kidney function declines with age in association with the development of age-associated glomerulosclerosis. The well-established structural and functional changes with age are reviewed briefly. The modification of aging pathology by calorie restriction is discussed. The role of the podocyte as a critical cell in the a...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1016/j.semnephrol.2009.07.012
更新日期:2009-11-01 00:00:00
abstract::IgA nephropathy (IgAN), a common primary glomerulonephritis worldwide, is associated with a substantial risk of progression to end-stage renal failure. The disease runs a highly variable clinical course with frequent involvement of tubulointerstitial damage. A subgroup of IgAN with proximal tubular epithelial cells (P...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1016/j.semnephrol.2018.05.018
更新日期:2018-09-01 00:00:00
abstract::Red cell production in chronic kidney disease is usually too low to maintain a normal haemoglobin, and thus anaemia develops in a large proportion of patients. The ability to stimulate erythropoiesis in the bone marrow by the use of therapeutic agents has only been possible in the last 20 years, initially with recombi...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1016/j.semnephrol.2006.05.008
更新日期:2006-07-01 00:00:00
abstract::The important role of hyperglycemia in the genesis of diabetic renal disease has been strengthened by tissue culture studies, experimental animal models, and clinical trials. A mechanistic understanding of the cellular and biochemical processes that link hyperglycemia with the development of diabetic nephropathy is in...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:
更新日期:1997-03-01 00:00:00
abstract::Cell-based therapy, designed to promote angiogenesis and improve organ function, has been under investigation for the treatment of ischemic heart disease for more than 10 years. Although believed to work primarily by repairing the microvasculature, this form of therapy has not been examined in the setting of chronic k...
journal_title:Seminars in nephrology
pub_type: 杂志文章
doi:10.1016/j.semnephrol.2012.07.012
更新日期:2012-09-01 00:00:00
abstract::In chronic kidney disease the excessive production of parathyroid hormone increases the bone resorption rate and leads to histologic bone signs of secondary hyperparathyroidism. However, in other situations, the initial increase in parathyroid hormone and bone remodeling may be slowed down excessively by a multitude o...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1016/j.semnephrol.2014.09.004
更新日期:2014-11-01 00:00:00
abstract::In most countries the prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection in peritoneal dialysis (PD) patients is lower than in hemodialysis (HD) patients. Besides a history of blood transfusions, previous HD is an important risk factor for developing HCV infection in PD patients. Many HCV-posi...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:
更新日期:2002-07-01 00:00:00
abstract::IgA nephropathy is one of the most common causes of glomerulonephritis in the world and is characterized histologically by the deposition of polymeric forms of IgA within the mesangium and in some cases along the glomerular capillary wall.(1) Proliferative and crescenteric forms of IgA are associated with nephrotic ra...
journal_title:Seminars in nephrology
pub_type: 杂志文章
doi:10.1016/j.semnephrol.2004.01.006
更新日期:2004-05-01 00:00:00
abstract::The renal biopsy provides critical diagnostic and prognostic information to clinicians including cases of acute kidney injury, chronic kidney disease, and allograft dysfunction. Today, biopsy specimens are read using a combination of light microscopy, electron microscopy, and indirect immunofluorescence, with a limite...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1016/j.semnephrol.2017.09.005
更新日期:2018-01-01 00:00:00
abstract::Besides loss of life and property, natural disasters result in a number of renal challenges, either by the creation of rhabdomyolysis and crush-induced acute kidney injury or by the destruction of existing dialysis facilities, leaving chronic dialysis patients and kidney transplanted patients without access to their r...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1016/j.semnephrol.2020.06.007
更新日期:2020-07-01 00:00:00
abstract::In chronic kidney disease (CKD), the progressive decrease in renal function leads to disturbances of mineral metabolism that generally cause secondary hyperparathyroidism. The increase in serum parathyroid hormone is associated with reduced serum calcium and calcitriol levels and/or increased serum fibroblast growth f...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1016/j.semnephrol.2018.02.004
更新日期:2018-05-01 00:00:00
abstract::Acute kidney injury (AKI) represents a common and devastating problem in clinical medicine. A major reason is the lack of early biomarkers for AKI, and hence an unacceptable delay in initiating therapy. Fortunately, the application of innovative technologies has uncovered several novel biomarkers. The most promising o...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1016/j.semnephrol.2008.05.010
更新日期:2008-09-01 00:00:00
abstract::Long-term continuous ambulatory peritoneal dialysis (CAPD) often causes peritoneal fibrosis and sclerosis with a loss of function, and some CAPD patients develop sclerosing encapsulating peritonitis. Glucose-based peritoneal dialysis fluids readily produce glucose degradation products by heat sterilization, and glucos...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1016/j.semnephrol.2004.06.027
更新日期:2004-09-01 00:00:00
abstract::In contrast to managing patients on hemodialysis in whom iron strategies are more focused on intravenous iron, nondialysis chronic kidney disease (CKD) patients may receive either oral or intravenous iron. There are advantages and disadvantages for both strategies. Oral iron is simple and cheap to administer and does ...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1016/j.semnephrol.2016.02.003
更新日期:2016-03-01 00:00:00
abstract::Hotspots of chronic kidney disease of unknown etiology (CKDu) have been identified throughout the globe, of which the Mesoamerican nephropathy in Central America is the most conspicuous example. It affects mainly agricultural workers, heat exposure during extenuating shifts leading to sudden dehydration and subsequent...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1016/j.semnephrol.2019.02.008
更新日期:2019-05-01 00:00:00
abstract::Toxic nephropathies cause acute and chronic renal failure, primarily as a result of injury to renal tubular epithelium. There is a well-known capacity in the renal nephron for the synchronous occurrence of both apoptosis and necrosis in toxic nephropathies. This has engendered interest in the differing or complementar...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1016/s0270-9295(03)00085-8
更新日期:2003-09-01 00:00:00