| Individualizing anaemia treatment: a discussion of case histories. | |
| | |
MedLine Citation:
|
PMID: 15958826 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
Current guidelines give evidence-based advice on how best to manage anaemia in patients with renal disease, but these guidelines do not consider individual patient needs, so tailoring anaemia management to each patient still remains a challenge for the treating physician. Two case studies are described that illustrate some of the key factors that need to be considered. The first case emphasizes that haemoglobin (Hb) targets recommended in current guidelines may not suit all patients. The patient had been stably maintained on subcutaneous epoetin therapy with an average Hb concentration of >13.0 g/dl because he developed angina symptoms when his Hb level fell to 12.2 g/dl. Iron deficiency was identified as the likely cause of falling Hb in this patient. After the patient's iron supplementation was increased, his Hb level was normalized back to >13.0 g/dl without increasing the epoetin dose, and the angina symptoms were resolved. The second case involved a pre-dialysis patient with diabetes, who required a higher dose of epoetin after beginning concomitant antihypertensive treatment with an angiotensin-converting enzyme inhibitor. Previously, the treatment of renal anaemia in pre-dialysis patients has not been the focus of attention. Two ongoing randomized controlled trials have been designed to study early initiation of epoetin treatment in pre-dialysis patients and will provide much needed information in this area. |
| | |
Authors:
|
Norman Muirhead |
Related Documents
:
|
10361896 - Gastrointestinal tract evaluation in patients with iron deficiency anemia. 8349196 - Pyruvate kinase (pk) deficiency in jordan. 20638166 - Analytical and biological variation in measures of anemia and iron status in patients t... 6729646 - Unusual presentation of multiple myeloma. a report of 2 cases. 18263686 - Autosomal dominant polycystic kidney disease is associated with an increased prevalence... 15227246 - Pentoxifylline therapy: a new adjunct in the treatment of pulmonary hypertension? |
Publication Detail:
|
Type: Case Reports; Journal Article |
Journal Detail:
|
Title: Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association Volume: 20 Suppl 6 ISSN: 0931-0509 ISO Abbreviation: Nephrol. Dial. Transplant. Publication Date: 2005 Jun |
Date Detail:
|
Created Date: 2005-06-16 Completed Date: 2005-12-06 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 8706402 Medline TA: Nephrol Dial Transplant Country: England |
Other Details:
|
Languages: eng Pagination: vi37-43 Citation Subset: IM |
Affiliation:
|
University of Western Ontario, London, Ontario, Canada. Norman.Muirhead@lhsc.on.ca |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Aged Anemia / blood, drug therapy*, etiology* Angiotensin-Converting Enzyme Inhibitors / therapeutic use Diabetes Mellitus, Type 2 / complications Dose-Response Relationship, Drug Epoetin Alfa / administration & dosage* Female Hematinics / administration & dosage* Hemoglobins Humans Hypertension / complications, drug therapy Kidney Failure, Chronic / blood, complications*, therapy Male Middle Aged Renal Dialysis |
| Chemical | |
Reg. No./Substance:
|
0/Angiotensin-Converting Enzyme Inhibitors; 0/Hematinics; 0/Hemoglobins; 113427-24-0/Epoetin Alfa |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Dose tailoring strategies in haemodialysis patients: a discussion of case histories.
Next Document: Pertussis toxin B-oligomer dissociates T cell activation and HIV replication in CD4 T cells released...