scholarly journals Iatrogenic Iron Overload in an End Stage Renal Disease Patient

2020 ◽  
Vol 13 (2) ◽  
pp. 760-763
Author(s):  
Majd M. Aldwairi ◽  
Mohamed A. Yassin
Keyword(s):  
Renal Failure ◽  
Blood Cell ◽  
Iron Overload ◽  
Red Blood Cell ◽  
Disease Patient ◽  
Intravenous Iron ◽  
Human Erythropoietin ◽  
Red Blood Cell Transfusions ◽  
Stage Renal Disease ◽  
End Stage

Iron overload is a common complication in patients with chronic renal failure treated with dialysis prior to the availability of recombinant human erythropoietin therapy. Iron overload was the result of hypoproliferative erythroid marrow function coupled with the need for frequent red blood cell transfusions to manage symptomatic anemia. The repetitive use of intravenous iron with or without the use of red blood cell transfusions also contributed to iron loading and was associated with iron deposition in liver parenchymal and reticuloendothelial cells. Here we report a 56-year-old female with end-stage renal failure who underwent kidney transplant twice and found to have iatrogenic iron overload with excess intravenous iron treated conservatively.

scholarly journals Hemodiafiltration improves red blood cell lifespan in patients with end‐stage renal disease

2021 ◽  
Author(s):  
Ying Jiang ◽  
Jiu‐Hong Li ◽  
Jun‐Feng Luo ◽  
Quan‐Sheng Han ◽  
Sheng‐Lang Zhu ◽  
...  
Keyword(s):  
Blood Cell ◽  
Renal Disease ◽  
Red Blood Cell ◽  
End Stage Renal Disease ◽  
Cell Lifespan ◽  
Stage Renal Disease ◽  
End Stage

scholarly journals Myelodysplastic syndrome: the other cause of anemia in end-stage renal disease patients undergoing dialysis

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Min-Yu Chang ◽  
Sheng-Fung Lin ◽  
Shih-Chi Wu ◽  
Wen-Chi Yang
Keyword(s):  
Blood Cell ◽  
Renal Disease ◽  
Myelodysplastic Syndrome ◽  
Red Blood Cell ◽  
End Stage Renal Disease ◽  
Refractory Anemia ◽  
Research Database ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Abstract In end-stage renal disease (ESRD) patients receiving dialysis, anemia is common and related to a higher mortality rate. Erythropoietin (EPO) resistance and iron refractory anemia require red blood cell transfusions. Myelodysplastic syndrome (MDS) is a disease with hematopoietic dysplasia. There are limited reports regarding ESRD patients with MDS. We aim to assess whether, for ESRD patients, undergoing dialysis is a predictive factor of MDS by analyzing data from the Taiwan National Health Insurance Research Database. We enrolled 74,712 patients with chronic renal failure (ESRD) who underwent dialysis and matched 74,712 control patients. In our study, we noticed that compared with the non-ESRD controls, in ESRD patients, undergoing dialysis (subdistribution hazard ratio [sHR] = 1.60, 1.16–2.19) and age (sHR = 1.03, 1.02–1.04) had positive predictive value for MDS occurrence. Moreover, more units of red blood cell transfusion (higher than 4 units per month) was also associated with a higher incidence of MDS. The MDS cumulative incidence increased with the duration of dialysis in ESRD patients. These effects may be related to exposure to certain cytokines, including interleukin-1, tumor necrosis factor-α, and tumor growth factor-β. In conclusion, we report the novel finding that ESRD patients undergoing dialysis have an increased risk of MDS.

Multiple red blood cell transfusions and iron overload in very low birthweight infants

Vox Sanguinis ◽  
2017 ◽  
Vol 112 (5) ◽  
pp. 453-458 ◽  
Author(s):  
J. D. Treviño-Báez ◽  
E. Briones-Lara ◽  
J. Alamillo-Velázquez ◽  
M. I. Martínez-Moreno
Keyword(s):  
Blood Cell ◽  
Iron Overload ◽  
Red Blood Cell ◽  
Low Birthweight ◽  
Very Low Birthweight ◽  
Red Blood Cell Transfusions ◽  
Very Low Birthweight Infants

scholarly journals Marrow transplantation for patients with thalassemia: results in class 3 patients

Blood ◽  
1996 ◽  
Vol 87 (5) ◽  
pp. 2082-2088 ◽  
Author(s):  
G Lucarelli ◽  
RA Clift ◽  
M Galimberti ◽  
P Polchi ◽  
E Angelucci ◽  
...  
Keyword(s):  
Blood Cell ◽  
Iron Overload ◽  
Liver Damage ◽  
Red Blood Cell ◽  
Marrow Transplantation ◽  
Proportional Hazards ◽  
Conditioning Regimen ◽  
Rejection Rate ◽  
Red Blood Cell Transfusions ◽  
Related Mortality

Thalassemia patients can be categorized as class 1 (minimal liver damage and iron overload), class 3 (extensive liver damage from iron overload), and class 2 (intermediate). These categories are prognostic for treatment outcome after marrow transplantation. Class 3 patients have more transplant-related mortality than other patients. This study examines transplantation outcome for class 3 patients. Records were reviewed of 215 patients in class 3 who received transplants in Pesaro from HLA-identical related donors between May 1, 1984 and May 1, 1994. The influence of pretransplant, peritransplant, and posttransplant variables on survival, relapse, and transplant-related mortality was examined by product-limit and proportional-hazards multivariate analysis. Age and conditioning regimen were influential on survival, and regimens with less than 200 mg/kg cyclosporine (CY) were associated with 5-year survival probabilities of .74 and .63 patients younger than 17 years and older patients, respectively. Transfusion history and regimen were influential on rejection with 5 year probabilities of .53 and .24 in patients who received less than or greater than 100 red blood cell transfusions before transplantation and regimens containing less than 200 mg/kg CY. Results of transplantation for patients with advanced thalassemia treatment have improved with the introduction of conditioning regimens with less CY. This has been associated with an increase in rejection (particularly in patients who have received < 100 red blood cell transfusions before transplant). Efforts at reducing the rejection rate by modifying the conditioning regimen should be concentrated on younger patients who have received a small number of transfusions. Patients with thalassemia who have HLA-identical family members should be transplanted before they are in class 3.

A 36-month analysis of treatment patterns and outcomes in patients with lower-risk myelodysplastic syndromes from a prospective observational study.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 7122-7122
Author(s):  
Roger M. Lyons ◽  
Billie J. Marek ◽  
Carole S. Paley ◽  
Jason Esposito ◽  
Lawrence E. Garbo ◽  
...  
Keyword(s):  
Blood Cell ◽  
Iron Overload ◽  
Red Blood Cell ◽  
Myelodysplastic Syndromes ◽  
Lower Risk ◽  
Cardiac Events ◽  
Risk Status ◽  
Red Blood Cell Transfusions ◽  
Lost To Follow Up ◽  
Ophthalmologic Disorders

7122 Background: Many patients (pts) with lower-risk myelodysplastic syndromes (MDS) require chronic red blood cell transfusions for symptomatic anemia, which can result in iron overload. We present a 36-month interim analysis of a 5-year US registry that prospectively collected data on clinical events and survival in chelated vs non-chelated, transfused, lower-risk MDS pts. Methods: This multicenter, non-interventional registry enrolled 600 pts ≥18 yr old with lower-risk MDS (WHO, FAB, and/or IPSS risk stratification criteria) and transfusional iron overload (serum ferritin ≥1,000 ng/mL and/or ≥20 packed red blood cell units and/or ≥6 units every 12 wks). The chelated group included pts who had received any chelation. Results: Median age was 76 yr (range, 21–99), 57.8% were male, and risk status was 38.6% IPSS low risk and 61.4% IPSS INT-1 risk. Baseline demographics and IPSS risk status were similar between groups, although transfusion burden trended higher in chelated pts. As of April 30, 2012, 169 pts continued on the registry, and 431 discontinued (345 died, 57.5%; 61 lost to follow-up, 10.2%; and 25 other, 4.2%). In all, 264 pts (44%) received chelation therapy; 200 had ≥6 mos chelation. Overall survival (OS) and time to acute myeloid leukemia (AML) transformation were significantly longer, and the percentage of deaths was significantly lower, in chelated ≥6 mos vs non-chelated pts (P<0.0001, P=0.011 [median not reached in either group], P=0.0002, respectively. AML transformations appeared to be lower in chelated ≥6 mos pts (not significant [NS]). At baseline in non-chelated vs chelated ≥6 mos pts, there was a higher prevalence of vascular, cardiac, endocrine, and ophthalmologic disorders; this trend continued at 36 mos. Most frequent causes of death were MDS/AML, cardiac events, and infection. Use of MDS therapy was lower among non-chelated pts (non-chelated, 88.4%; ≥6 mos chelation, 93.5%; NS). Conclusions: At 36 mos,chelated pts had significantly longer OS and time to AML, as well as significantly fewer deaths. Trends toward fewer AML transformations and fewer vascular, cardiac, endocrine, and ophthalmologic disorders were observed in chelated pts.

The assessment of serum nontransferrin-bound iron in chelation therapy and iron supplementation

Blood ◽  
2000 ◽  
Vol 95 (9) ◽  
pp. 2975-2982 ◽  
Author(s):  
William Breuer ◽  
Aharon Ronson ◽  
Itzchak N. Slotki ◽  
Ayala Abramov ◽  
Chaim Hershko ◽  
...  
Keyword(s):  
Iron Overload ◽  
Iron Status ◽  
Hereditary Hemochromatosis ◽  
Intravenous Iron ◽  
Iron Chelator ◽  
Enzyme Linked Immunosorbent Assay ◽  
Simple Method ◽  
Stage Renal Disease ◽  
End Stage ◽  
Iron Chelator Deferoxamine

Nontransferrin-bound iron (NTBI) appears in the serum of individuals with iron overload and in a variety of other pathologic conditions. Because NTBI constitutes a labile form of iron, it might underlie some of the biologic damage associated with iron overload. We have developed a simple method for NTBI determination, which operates in a 96-well enzyme-linked immunosorbent assay format with sensitivity comparable to that of previous assays. A weak ligand, oxalic acid, mobilizes the NTBI and mediates its transfer to the iron chelator deferoxamine (DFO) immobilized on the plate. The amount of DFO-bound iron, originating from NTBI, is quantitatively revealed in a fluorescence plate reader by the fluorescent metallosensor calcein. No NTBI is found in normal sera because transferrin-bound iron is not detected in the assay. Thalassemic sera contained NTBI in 80% of the cases (range, 0.9-12.8 μmol/L). In patients given intravenous infusions of DFO, NTBI initially became undetectable due to the presence of DFO in the sera, but reappeared in 55% of the cases within an hour of cessation of the DFO infusion. This apparent rebound was attributable to the loss of DFO from the circulation and the possibility that a major portion of NTBI was not mobilized by DFO. NTBI was also found in patients with end-stage renal disease who were treated for anemia with intravenous iron supplements and in patients with hereditary hemochromatosis, at respective frequencies of 22% and 69%. The availability of a simple assay for monitoring NTBI could provide a useful index of iron status during chelation and supplementation treatments.

Red blood cell abnormalities and the pathogenesis of anemia in end-stage renal disease

2016 ◽  
Vol 10 (8) ◽  
pp. 778-790 ◽  
Author(s):  
Hara T. Georgatzakou ◽  
Marianna H. Antonelou ◽  
Issidora S. Papassideri ◽  
Anastasios G. Kriebardis
Keyword(s):  
Blood Cell ◽  
Renal Disease ◽  
Red Blood Cell ◽  
End Stage Renal Disease ◽  
Stage Renal Disease ◽  
End Stage
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