Overcoming barriers that inhibit proper treatment of anemia

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Intravenous (i.v.) iron and recombinant human erythropoietin (EPO), like all other medications, are associated with the risk of adverse events. Historically, the primary concern with iron therapy has been the possibility of iron overload, which exposes the individual to the effects associated with nontransferrin-bound iron. Experience with EPO use has demonstrated an association with hypertension and with the upregulation of a number of markers of inflammation. The impact of these potential adverse effects merits careful analysis, given that both i.v. iron and EPO are designed for long-term use in a patient population at high risk for infection and cardiovascular disease. However, the incidence of iron overload and the risks associated with nontransferrin-bound iron have dramatically been reduced since the introduction of EPO therapy, and no data exist that demonstrate a definitive association between i.v. iron and an increased risk of morbidity related to infection or cardiovascular disease. On the other hand, EPO use is associated with hypertension, endothelial dysfunction, and prothrombotic and inflammatory states in hemodialysis patients. Risks associated with hypertension can be minimized by using the lowest effective EPO dose, which may be achieved through the regular use of i.v. iron. Judicious use of both i.v. iron and EPO may optimize cardiovascular outcomes.

Original languageEnglish
JournalKidney International
Volume69
Issue numberSUPPL. 101
DOIs
StatePublished - May 2006

Fingerprint

Erythropoietin
Anemia
Iron
Iron Overload
Therapeutics
Hypertension
Cardiovascular Diseases
Infection
Renal Dialysis
Up-Regulation
Inflammation
Morbidity
Incidence

Keywords

  • Anemia
  • Erythropoietin
  • Hypertension
  • i.v. iron
  • Iron overload
  • Renal failure

ASJC Scopus subject areas

  • Nephrology

Cite this

Overcoming barriers that inhibit proper treatment of anemia. / Agarwal, Rajiv.

In: Kidney International, Vol. 69, No. SUPPL. 101, 05.2006.

Research output: Contribution to journalArticle

@article{7f454bfaacd1476fa4474dc51c322d3e,
title = "Overcoming barriers that inhibit proper treatment of anemia",
abstract = "Intravenous (i.v.) iron and recombinant human erythropoietin (EPO), like all other medications, are associated with the risk of adverse events. Historically, the primary concern with iron therapy has been the possibility of iron overload, which exposes the individual to the effects associated with nontransferrin-bound iron. Experience with EPO use has demonstrated an association with hypertension and with the upregulation of a number of markers of inflammation. The impact of these potential adverse effects merits careful analysis, given that both i.v. iron and EPO are designed for long-term use in a patient population at high risk for infection and cardiovascular disease. However, the incidence of iron overload and the risks associated with nontransferrin-bound iron have dramatically been reduced since the introduction of EPO therapy, and no data exist that demonstrate a definitive association between i.v. iron and an increased risk of morbidity related to infection or cardiovascular disease. On the other hand, EPO use is associated with hypertension, endothelial dysfunction, and prothrombotic and inflammatory states in hemodialysis patients. Risks associated with hypertension can be minimized by using the lowest effective EPO dose, which may be achieved through the regular use of i.v. iron. Judicious use of both i.v. iron and EPO may optimize cardiovascular outcomes.",
keywords = "Anemia, Erythropoietin, Hypertension, i.v. iron, Iron overload, Renal failure",
author = "Rajiv Agarwal",
year = "2006",
month = "5",
doi = "10.1038/sj.ki.5000403",
language = "English",
volume = "69",
journal = "Kidney International",
issn = "0085-2538",
publisher = "Nature Publishing Group",
number = "SUPPL. 101",

}

TY - JOUR

T1 - Overcoming barriers that inhibit proper treatment of anemia

AU - Agarwal, Rajiv

PY - 2006/5

Y1 - 2006/5

N2 - Intravenous (i.v.) iron and recombinant human erythropoietin (EPO), like all other medications, are associated with the risk of adverse events. Historically, the primary concern with iron therapy has been the possibility of iron overload, which exposes the individual to the effects associated with nontransferrin-bound iron. Experience with EPO use has demonstrated an association with hypertension and with the upregulation of a number of markers of inflammation. The impact of these potential adverse effects merits careful analysis, given that both i.v. iron and EPO are designed for long-term use in a patient population at high risk for infection and cardiovascular disease. However, the incidence of iron overload and the risks associated with nontransferrin-bound iron have dramatically been reduced since the introduction of EPO therapy, and no data exist that demonstrate a definitive association between i.v. iron and an increased risk of morbidity related to infection or cardiovascular disease. On the other hand, EPO use is associated with hypertension, endothelial dysfunction, and prothrombotic and inflammatory states in hemodialysis patients. Risks associated with hypertension can be minimized by using the lowest effective EPO dose, which may be achieved through the regular use of i.v. iron. Judicious use of both i.v. iron and EPO may optimize cardiovascular outcomes.

AB - Intravenous (i.v.) iron and recombinant human erythropoietin (EPO), like all other medications, are associated with the risk of adverse events. Historically, the primary concern with iron therapy has been the possibility of iron overload, which exposes the individual to the effects associated with nontransferrin-bound iron. Experience with EPO use has demonstrated an association with hypertension and with the upregulation of a number of markers of inflammation. The impact of these potential adverse effects merits careful analysis, given that both i.v. iron and EPO are designed for long-term use in a patient population at high risk for infection and cardiovascular disease. However, the incidence of iron overload and the risks associated with nontransferrin-bound iron have dramatically been reduced since the introduction of EPO therapy, and no data exist that demonstrate a definitive association between i.v. iron and an increased risk of morbidity related to infection or cardiovascular disease. On the other hand, EPO use is associated with hypertension, endothelial dysfunction, and prothrombotic and inflammatory states in hemodialysis patients. Risks associated with hypertension can be minimized by using the lowest effective EPO dose, which may be achieved through the regular use of i.v. iron. Judicious use of both i.v. iron and EPO may optimize cardiovascular outcomes.

KW - Anemia

KW - Erythropoietin

KW - Hypertension

KW - i.v. iron

KW - Iron overload

KW - Renal failure

UR - http://www.scopus.com/inward/record.url?scp=33749844816&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33749844816&partnerID=8YFLogxK

U2 - 10.1038/sj.ki.5000403

DO - 10.1038/sj.ki.5000403

M3 - Article

C2 - 16830700

AN - SCOPUS:33746575744

VL - 69

JO - Kidney International

JF - Kidney International

SN - 0085-2538

IS - SUPPL. 101

ER -