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Article ; Online: Within-patient variation of hemoglobin and reticulocytes: implications for evaluating ESA responsiveness in dialysis patients.

Van Wyck, D B / Giles, I / Sharpe, K

International journal of laboratory hematology

2012 Volume 34, Issue 6, Page(s) 577–583

Abstract: Introduction: Techniques that assess percent reticulocytes (%retics) or hemoglobin (Hb) to detect erythropoiesis-stimulating agents (ESA) use in athletes may be useful in evaluating ESA responsiveness in dialysis patients. However, within-patient ... ...

Abstract	Introduction: Techniques that assess percent reticulocytes (%retics) or hemoglobin (Hb) to detect erythropoiesis-stimulating agents (ESA) use in athletes may be useful in evaluating ESA responsiveness in dialysis patients. However, within-patient variation, appropriate transformation, or the relationship between the blood draw interval length and analyte variation are untested. Methods: In a prospective, single-arm trial, we determined Hb and %retics in 30 hemodialysis patients receiving stable ESA doses. Within-patient results were evaluated for variance homogeneity and normality with and without transformation. Results: Square-root transformation (sqrt) of %retics produced the most constant variance (lowest r-value for correlation between sqrt\|normalized residuals\| and fitted values: 0.018 highest P-value 0.739) compared with log transformation (r = -0.198, P < 0.001) or no transformation (r = 0.215, P < 0.001) and showed the least departure from normality (highest P-value: 0.002 vs. < 0.001 vs. < 0.001, respectively). Hb results did not improve with transformation. Within-patient variance in both %retics and Hb increased with interval length between lab draws (P < 0.001). Conclusions: Initial assessment of anti-doping tool use in dialysis patient anemia management indicates square-root transformation of %retics and adjustment for time between lab draw intervals for both %retics and Hb will be required.
MeSH term(s)	Anemia/blood ; Anemia/therapy ; Epoetin Alfa/administration & dosage ; Epoetin Alfa/therapeutic use ; Female ; Hematinics/administration & dosage ; Hematinics/therapeutic use ; Hemoglobins/analysis ; Humans ; Iron/administration & dosage ; Iron/therapeutic use ; Linear Models ; Longitudinal Studies ; Male ; Middle Aged ; Prospective Studies ; Renal Dialysis ; Reticulocyte Count
Chemical Substances	Hematinics ; Hemoglobins ; Epoetin Alfa (64FS3BFH5W) ; Iron (E1UOL152H7)
Language	English
Publishing date	2012-12
Publishing country	England
Document type	Journal Article ; Observational Study ; Research Support, Non-U.S. Gov't
ZDB-ID	2268590-X
ISSN	1751-553X ; 1751-5521 ; 0141-9854
ISSN (online)	1751-553X
ISSN	1751-5521 ; 0141-9854
DOI	10.1111/j.1751-553X.2012.01435.x
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Article: Lessons from NKF-DOQI: iron management.

Van Wyck, D B

Seminars in nephrology

2000 Volume 20, Issue 4, Page(s) 330–334

MeSH term(s)	Administration, Oral ; Anemia, Iron-Deficiency/drug therapy ; Anemia, Iron-Deficiency/etiology ; Erythropoietin/administration & dosage ; Female ; Humans ; Injections, Intravenous ; Iron/administration & dosage ; Iron/metabolism ; Kidney Failure, Chronic/complications ; Kidney Failure, Chronic/therapy ; Male ; Outcome Assessment (Health Care) ; Prognosis ; Recombinant Proteins ; Renal Dialysis ; Treatment Outcome
Chemical Substances	Recombinant Proteins ; Erythropoietin (11096-26-7) ; Iron (E1UOL152H7)
Language	English
Publishing date	2000-07
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	604652-6
ISSN	1558-4488 ; 0270-9295
ISSN (online)	1558-4488
ISSN	0270-9295
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Article: Management of early renal anaemia: diagnostic work-up, iron therapy, epoetin therapy.

Van Wyck, D B

Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association

2000 Volume 15 Suppl 3, Page(s) 36–39

Abstract: Effective management of early anaemia in the course of chronic renal insufficiency requires the following: (i) implementing an efficient diagnostic strategy to exclude common contributing factors; (ii) initiating epoetin therapy for the majority of ... ...

Abstract	Effective management of early anaemia in the course of chronic renal insufficiency requires the following: (i) implementing an efficient diagnostic strategy to exclude common contributing factors; (ii) initiating epoetin therapy for the majority of patients; for and (iii) ensuring adequate iron supply erythropoiesis. Diagnostic inquiry is warranted whenever the haemoglobin concentration is below the normal range adjusted for age and gender. The most efficient diagnostic approach is to assume erythropoietin deficiency, exclude iron deficiency, and pursue further diagnostic tests only when red-cell indices are abnormal or when leukopenia or thrombocytopenia are also present. Macrocytosis should prompt an inquiry into alcoholism, B12 deficiency, or folate deficiency. Microcytosis suggests iron deficiency or thalassaemia. Associated cytopenias raise the possibility of alcohol toxicity, pernicious anaemia, malignancy, or myelodysplastic syndrome. Epoetin therapy is warranted whenever the haemoglobin concentration has fallen below 10.0 g/dl. To initiate therapy prior to dialysis, epoetin should be administered at an average dose of 100 IU/kg/week (80-120 IU/kg/week, 50-150 IU/kg/ week) by subcutaneous injection. Haemoglobin concentration should be monitored every 2 weeks and the epoetin dose adjusted by increments or decrements of 25% to maintain a rate of rise of haemoglobin concentration of 0.2-0.6 g/dl (0.3 0.6 g/dl/week, 0.2-0.5 g/dl/week). When the target range is achieved, the dose of epoetin should be continually adjusted to maintain a stable haemoglobin concentration. Transferrin saturation and ferritin concentration should be monitored monthly, and sufficient iron provided to maintain transferrin saturation above 20%. The lower the haemoglobin concentration, the greater the likelihood that future intravenous iron will be required. Oral iron supplements should be avoided, since they are costly, ineffective, and troublesome to patients. Finally, a blunted therapeutic response to epoetin therapy provides important diagnostic information and gnostic inquiry.
MeSH term(s)	Anemia/diagnosis ; Anemia/drug therapy ; Anemia/etiology ; Erythropoietin/therapeutic use ; Humans ; Iron/therapeutic use ; Kidney Failure, Chronic/blood ; Recombinant Proteins/therapeutic use
Chemical Substances	Recombinant Proteins ; Erythropoietin (11096-26-7) ; Iron (E1UOL152H7)
Language	English
Publishing date	2000
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	90594-x
ISSN	1460-2385 ; 0931-0509
ISSN (online)	1460-2385
ISSN	0931-0509
DOI	10.1093/oxfordjournals.ndt.a027975
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Zs.A 2198: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Safety of intravenous ferric carboxymaltose versus oral iron in patients with nondialysis-dependent CKD: an analysis of the 1-year FIND-CKD trial.

Roger, Simon D / Gaillard, Carlo A / Bock, Andreas H / Carrera, Fernando / Eckardt, Kai-Uwe / Van Wyck, David B / Cronin, Maureen / Meier, Yvonne / Larroque, Sylvain / Macdougall, Iain C

Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association

2017 Volume 32, Issue 9, Page(s) 1530–1539

Abstract: Background: The evidence base regarding the safety of intravenous (IV) iron therapy in patients with chronic kidney disease (CKD) is incomplete and largely based on small studies of relatively short duration.: Methods: FIND-CKD (ClinicalTrials.gov ... ...

Abstract	Background: The evidence base regarding the safety of intravenous (IV) iron therapy in patients with chronic kidney disease (CKD) is incomplete and largely based on small studies of relatively short duration. Methods: FIND-CKD (ClinicalTrials.gov number NCT00994318) was a 1-year, open-label, multicenter, prospective study of patients with nondialysis-dependent CKD, anemia and iron deficiency randomized (1:1:2) to IV ferric carboxymaltose (FCM), targeting higher (400-600 µg/L) or lower (100-200 µg/L) ferritin, or oral iron. A post hoc analysis of adverse event rates per 100 patient-years was performed to assess the safety of FCM versus oral iron over an extended period. Results: The safety population included 616 patients. The incidence of one or more adverse events was 91.0, 100.0 and 105.0 per 100 patient-years in the high ferritin FCM, low ferritin FCM and oral iron groups, respectively. The incidence of adverse events with a suspected relation to study drug was 15.9, 17.8 and 36.7 per 100 patient-years in the three groups; for serious adverse events, the incidence was 28.2, 27.9 and 24.3 per 100 patient-years. The incidence of cardiac disorders and infections was similar between groups. At least one ferritin level ≥800 µg/L occurred in 26.6% of high ferritin FCM patients, with no associated increase in adverse events. No patient with ferritin ≥800 µg/L discontinued the study drug due to adverse events. Estimated glomerular filtration rate remained the stable in all groups. Conclusions: These results further support the conclusion that correction of iron deficiency anemia with IV FCM is safe in patients with nondialysis-dependent CKD.
MeSH term(s)	Administration, Intravenous ; Administration, Oral ; Aged ; Anemia, Iron-Deficiency/drug therapy ; Anemia, Iron-Deficiency/etiology ; Female ; Ferric Compounds/administration & dosage ; Glomerular Filtration Rate ; Humans ; Iron/administration & dosage ; Male ; Maltose/administration & dosage ; Maltose/analogs & derivatives ; Prospective Studies ; Renal Insufficiency, Chronic/complications ; Time Factors
Chemical Substances	Ferric Compounds ; ferric carboxymaltose (6897GXD6OE) ; Maltose (69-79-4) ; Iron (E1UOL152H7)
Language	English
Publishing date	2017-03-23
Publishing country	England
Document type	Journal Article ; Multicenter Study ; Randomized Controlled Trial
ZDB-ID	90594-x
ISSN	1460-2385 ; 0931-0509
ISSN (online)	1460-2385
ISSN	0931-0509
DOI	10.1093/ndt/gfw264
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Article ; Online: Hepcidin Response to Iron Therapy in Patients with Non-Dialysis Dependent CKD: An Analysis of the FIND-CKD Trial.

Gaillard, Carlo A / Bock, Andreas H / Carrera, Fernando / Eckardt, Kai-Uwe / Van Wyck, David B / Bansal, Sukhvinder S / Cronin, Maureen / Meier, Yvonne / Larroque, Sylvain / Roger, Simon D / Macdougall, Iain C

PloS one

2016 Volume 11, Issue 6, Page(s) e0157063

Abstract: Hepcidin is the key regulator of iron homeostasis but data are limited regarding its temporal response to iron therapy, and response to intravenous versus oral iron. In the 56-week, open-label, multicenter, prospective, randomized FIND-CKD study, 626 ... ...

Abstract	Hepcidin is the key regulator of iron homeostasis but data are limited regarding its temporal response to iron therapy, and response to intravenous versus oral iron. In the 56-week, open-label, multicenter, prospective, randomized FIND-CKD study, 626 anemic patients with non-dialysis dependent chronic kidney disease (ND-CKD) and iron deficiency not receiving an erythropoiesis stimulating agent were randomized (1:1:2) to intravenous ferric carboxymaltose (FCM), targeting higher (400-600μg/L) or lower (100-200μg/L) ferritin, or to oral iron. Serum hepcidin levels were measured centrally in a subset of 61 patients. Mean (SD) baseline hepcidin level was 4.0(3.5), 7.3(6.4) and 6.5(5.6) ng/mL in the high ferritin FCM (n = 17), low ferritin FCM (n = 16) and oral iron group (n = 28). The mean (SD) endpoint value (i.e. the last post-baseline value) was 26.0(9.1),15.7(7.7) and 16.3(11.0) ng/mL, respectively. The increase in hepcidin from baseline was significantly smaller with low ferritin FCM or oral iron vs high ferritin FCM at all time points up to week 52. Significant correlations were found between absolute hepcidin and ferritin values (r = 0.65, p<0.001) and between final post-baseline increases in both parameters (r = 0.70, p<0.001). The increase in hepcidin levels over the 12-month study generally mirrored the cumulative iron dose in each group. Hepcidin and transferrin saturation (TSAT) absolute values showed no correlation, although there was an association between final post-baseline increases (r = 0.42, p<0.001). Absolute values (r = 0.36, p = 0.004) and final post-baseline increases of hepcidin and hemoglobin (p = 0.30, p = 0.030) correlated weakly. Baseline hepcidin levels were not predictive of a hematopoietic response to iron therapy. In conclusion, hepcidin levels rose in response to either intravenous or oral iron therapy, but the speed and extent of the rise was greatest with intravenous iron targeting a higher ferritin level. However neither the baseline level nor the change in hepcidin was able to predict response to therapy in this cohort.
MeSH term(s)	Administration, Intravenous ; Aged ; Aged, 80 and over ; Anemia, Iron-Deficiency/blood ; Anemia, Iron-Deficiency/drug therapy ; Anemia, Iron-Deficiency/etiology ; Female ; Ferric Compounds/administration & dosage ; Ferritins/blood ; Hepcidins/blood ; Humans ; Iron/administration & dosage ; Male ; Maltose/administration & dosage ; Maltose/analogs & derivatives ; Middle Aged ; Prospective Studies ; Renal Insufficiency, Chronic/blood ; Renal Insufficiency, Chronic/complications ; Renal Insufficiency, Chronic/drug therapy ; Time Factors
Chemical Substances	Ferric Compounds ; HAMP protein, human ; Hepcidins ; ferric carboxymaltose (6897GXD6OE) ; Maltose (69-79-4) ; Ferritins (9007-73-2) ; Iron (E1UOL152H7)
Language	English
Publishing date	2016-06-08
Publishing country	United States
Document type	Journal Article ; Multicenter Study ; Randomized Controlled Trial
ISSN	1932-6203
ISSN (online)	1932-6203
DOI	10.1371/journal.pone.0157063
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Article: Impact of erythropoietin on the dialysis prescription.

Van Wyck, D B

American journal of kidney diseases : the official journal of the National Kidney Foundation

1991 Volume 18, Issue 4 Suppl 1, Page(s) 71–75

Abstract: Close on the heals of the first successful reports of recombinant human erythropoietin (rHuEPO) use in dialysis-associated anemia, concern surfaced that raising the hematocrit level could threaten both the safety and efficacy of hemodialysis. Theoretical ...

Abstract	Close on the heals of the first successful reports of recombinant human erythropoietin (rHuEPO) use in dialysis-associated anemia, concern surfaced that raising the hematocrit level could threaten both the safety and efficacy of hemodialysis. Theoretical considerations prompted the conclusion that by decreasing the plasma water space available for dialysis, removal of plasma solutes would decrease in direct proportion to the increase in hematocrit. Predictions of thrombotic disaster were also aired, citing the increase in blood viscosity expected after correction of anemia. After 18 months of widespread use of rHuEPO in the United States, clinical experience has shown that correction of anemia can be accomplished without serious impact on either safety or efficacy in both conventional and high efficiency/high dialysis. Although predialysis concentrations of creatinine, phosphate, and potassium may increase whenever the hematocrit increases substantially, the magnitude of the rise is limited. Increased predialysis solute concentrations, which may be caused by either decreased dialyzer efficiency or increased dietary intake due to improved appetite, are readily managed by increasing dialysis blood flow rate, dialyzer surface area, and dialysis time. Since these measures may have little effect on increased phosphate levels, increased administration of phosphate binders may be required. However, by way of caution, the ready dialyzability of urea renders the predialysis blood urea nitrogen (BUN), as well as urea kinetics, relatively unaffected by the change in hematocrit, thereby masking adverse effects on other solutes. Fortunately, serious thrombotic consequences have not been seen, probably because anticoagulation is adequately managed by routine increases in heparin utilization.
MeSH term(s)	Anemia/blood ; Anemia/etiology ; Anemia/therapy ; Erythropoietin/adverse effects ; Erythropoietin/therapeutic use ; Hematocrit ; Humans ; Kidney Failure, Chronic/blood ; Kidney Failure, Chronic/complications ; Kidney Failure, Chronic/therapy ; Recombinant Proteins/adverse effects ; Recombinant Proteins/therapeutic use ; Renal Dialysis
Chemical Substances	Recombinant Proteins ; Erythropoietin (11096-26-7)
Language	English
Publishing date	1991-10
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	604539-x
ISSN	1523-6838 ; 0272-6386
ISSN (online)	1523-6838
ISSN	0272-6386
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Zs.A 1669: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article: Iron deficiency in patients with dialysis-associated anemia during erythropoietin replacement therapy: strategies for assessment and management.

Van Wyck, D B

Seminars in nephrology

1989 Volume 9, Issue 1 Suppl 2, Page(s) 21–24

Abstract: Iron deficiency frequently complicates both acute and chronic phases of recombinant human erythropoietin (r-HuEPO; EPOGEN [epoetin alfa], AMGEN Inc, Thousand Oaks, CA) therapy for dialysis-associated anemia. During acute correction of anemia, iron needed ...

Abstract	Iron deficiency frequently complicates both acute and chronic phases of recombinant human erythropoietin (r-HuEPO; EPOGEN [epoetin alfa], AMGEN Inc, Thousand Oaks, CA) therapy for dialysis-associated anemia. During acute correction of anemia, iron needed for new hemoglobin production may outstrip available body iron stores. During maintenance r-HuEPO therapy, blood lost both through the dialysis process and the uremic predisposition to gastrointestinal bleeding promotes ongoing negative iron balance. Failure to recognize and treat iron deficiency may lead to impaired efficacy of r-HuEPO in the anemic patient by converting the anemia associated with chronic renal failure to the anemia associated with iron deficiency. The risk of iron deficiency is assessed by weighing available iron stores, as reflected by the level of serum ferritin, against anticipated iron needs for new hemoglobin synthesis, as measured by the difference between the current and target hemoglobin. Using this approach, body iron reserves can be determined, iron deficits predicted, and appropriate iron replacement therapy planned. Once patients are identified as being at risk for iron deficiency, they are treated prophylactically with oral iron supplements. Parenteral iron therapy is reserved for those at greatest risk for iron deficiency during acute r-HuEPO treatment and those intolerant or unresponsive to oral iron supplements during chronic r-HuEPO treatment. Although no dose-response relationship has been observed in the restoration of iron balance with oral iron supplements, those taking supplements show distinctly higher projected iron stores and daily iron balance than those not given supplements.
MeSH term(s)	Anemia/drug therapy ; Anemia/etiology ; Anemia, Hypochromic/etiology ; Anemia, Hypochromic/prevention & control ; Erythropoietin/therapeutic use ; Humans ; Iron/metabolism ; Kidney Failure, Chronic/complications ; Recombinant Proteins/therapeutic use ; Renal Dialysis
Chemical Substances	Recombinant Proteins ; Erythropoietin (11096-26-7) ; Iron (E1UOL152H7)
Language	English
Publishing date	1989-03
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	604652-6
ISSN	1558-4488 ; 0270-9295
ISSN (online)	1558-4488
ISSN	0270-9295
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Article: Iron management during recombinant human erythropoietin therapy.

Van Wyck, D B

American journal of kidney diseases : the official journal of the National Kidney Foundation

1989 Volume 14, Issue 2 Suppl 1, Page(s) 9–13

Abstract: Treatment with recombinant human erythropoietin (r-HuEPO; EPOGEN [epoetin alfa], AMGEN Inc, Thousand Oaks, CA) rapidly corrects the anemia associated with end-stage renal disease during the acute phase of therapy and supports hematocrit levels throughout ...

Abstract	Treatment with recombinant human erythropoietin (r-HuEPO; EPOGEN [epoetin alfa], AMGEN Inc, Thousand Oaks, CA) rapidly corrects the anemia associated with end-stage renal disease during the acute phase of therapy and supports hematocrit levels throughout the maintenance phase. However, during the acute phase of therapy, iron deficiency will develop in most patients; it is therefore initially essential to monitor body iron stores monthly. A plasma ferritin level of less than 30 ng/mL or a transferrin saturation level of less than 20% confirms the diagnosis of iron deficiency. Microcytic, hypochromic red cell morphology appears only after prolonged iron deficiency due to inadequate monitoring and insufficient iron supplementation; alternatively, microcytosis in the presence of adequate iron stores suggests aluminum toxicity. In all patients except those with transfusional iron overload, prophylactic supplementation with ferrous sulfate (325 mg up to three times daily) is recommended. When oral supplements, which are poorly tolerated at high doses, are insufficient to meet the extraordinary needs resulting from r-HuEPO-induced erythropoiesis, intravenous iron dextran (500 to 1,000 mg administered in five to ten doses) may be required. During the maintenance phase of therapy, it may be necessary to continue iron supplementation to counteract ongoing loss of iron associated with blood loss through dialyzers and gastrointestinal bleeding. At the other extreme of iron balance, iron overload in transfusion-dependent patients, recent studies suggest that the ability of r-HuEPO to mobilize iron stores can be harnessed with therapeutic phlebotomy to reverse transfusional iron overload.
MeSH term(s)	Adult ; Anemia/drug therapy ; Anemia/etiology ; Anemia, Hypochromic/prevention & control ; Delayed-Action Preparations/therapeutic use ; Erythropoietin/therapeutic use ; Ferrous Compounds/therapeutic use ; Hematocrit ; Humans ; Iron-Dextran Complex/therapeutic use ; Kidney Failure, Chronic/complications ; Male ; Recombinant Proteins/therapeutic use
Chemical Substances	Delayed-Action Preparations ; Ferrous Compounds ; Recombinant Proteins ; Erythropoietin (11096-26-7) ; ferrous sulfate (39R4TAN1VT) ; Iron-Dextran Complex (9004-66-4)
Language	English
Publishing date	1989-08
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	604539-x
ISSN	1523-6838 ; 0272-6386
ISSN (online)	1523-6838
ISSN	0272-6386
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Article: Overwhelming postsplenectomy infection (OPSI): the clinical syndrome.

Van Wyck, D B

Lymphology

1983 Volume 16, Issue 2, Page(s) 107–114

Abstract: Critical examination of the infectious risk following splenectomy raises questions about several widely held notions. True hazard of OPSI is difficult to quantify and probably underestimated, susceptibility is life-long, questionably altered by splenosis, ...

Abstract	Critical examination of the infectious risk following splenectomy raises questions about several widely held notions. True hazard of OPSI is difficult to quantify and probably underestimated, susceptibility is life-long, questionably altered by splenosis, and persists despite penicillin prophylaxis and vaccination against common pneumococcal serotypes.
MeSH term(s)	Diagnosis, Differential ; Humans ; Pneumococcal Infections/diagnosis ; Postoperative Complications ; Risk ; Splenectomy/adverse effects ; Syndrome
Language	English
Publishing date	1983-06
Publishing country	United States
Document type	Journal Article
ZDB-ID	80181-1
ISSN	0024-7766
ISSN	0024-7766
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Article ; Online: Hepcidin Response to Iron Therapy in Patients with Non-Dialysis Dependent CKD

Carlo A Gaillard / Andreas H Bock / Fernando Carrera / Kai-Uwe Eckardt / David B Van Wyck / Sukhvinder S Bansal / Maureen Cronin / Yvonne Meier / Sylvain Larroque / Simon D Roger / Iain C Macdougall

PLoS ONE, Vol 11, Iss 6, p e

An Analysis of the FIND-CKD Trial.

2016 Volume 0157063

Abstract	Hepcidin is the key regulator of iron homeostasis but data are limited regarding its temporal response to iron therapy, and response to intravenous versus oral iron. In the 56-week, open-label, multicenter, prospective, randomized FIND-CKD study, 626 anemic patients with non-dialysis dependent chronic kidney disease (ND-CKD) and iron deficiency not receiving an erythropoiesis stimulating agent were randomized (1:1:2) to intravenous ferric carboxymaltose (FCM), targeting higher (400-600μg/L) or lower (100-200μg/L) ferritin, or to oral iron. Serum hepcidin levels were measured centrally in a subset of 61 patients. Mean (SD) baseline hepcidin level was 4.0(3.5), 7.3(6.4) and 6.5(5.6) ng/mL in the high ferritin FCM (n = 17), low ferritin FCM (n = 16) and oral iron group (n = 28). The mean (SD) endpoint value (i.e. the last post-baseline value) was 26.0(9.1),15.7(7.7) and 16.3(11.0) ng/mL, respectively. The increase in hepcidin from baseline was significantly smaller with low ferritin FCM or oral iron vs high ferritin FCM at all time points up to week 52. Significant correlations were found between absolute hepcidin and ferritin values (r = 0.65, p<0.001) and between final post-baseline increases in both parameters (r = 0.70, p<0.001). The increase in hepcidin levels over the 12-month study generally mirrored the cumulative iron dose in each group. Hepcidin and transferrin saturation (TSAT) absolute values showed no correlation, although there was an association between final post-baseline increases (r = 0.42, p<0.001). Absolute values (r = 0.36, p = 0.004) and final post-baseline increases of hepcidin and hemoglobin (p = 0.30, p = 0.030) correlated weakly. Baseline hepcidin levels were not predictive of a hematopoietic response to iron therapy. In conclusion, hepcidin levels rose in response to either intravenous or oral iron therapy, but the speed and extent of the rise was greatest with intravenous iron targeting a higher ferritin level. However neither the baseline level nor the change in hepcidin was ...
Keywords	Medicine ; R ; Science ; Q
Subject code	610
Language	English
Publishing date	2016-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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In stock of ZB MED Cologne/Königswinter

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In stock of ZB MED Cologne/Königswinter

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In stock of ZB MED Cologne/Königswinter

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In stock of ZB MED Cologne/Königswinter

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Inter-library loan at ZB MED