Increase In Hb Levels Research Articles

Effect of voxelotor on cerebral perfusion and cerebral oxygen metabolism and cardiac stress in adult patients with sickle cell disease.

Sickle cell disease (SCD) is complicated by silent cerebral infarcts (SCIs), for which anemia is an important risk factor. Despite normal oxygen delivery (OD), cerebral vascular reserve (CVR), and cerebral metabolic rate of oxygen (CMRO2) are diminished in SCD, possibly causing the formation of SCIs. Voxelotor inhibits polymerization by increasing the hemoglobin oxygen binding, ameliorating hemolytic anemia. Furthermore, anemia is related to cardiac complications. Our aims were to assess the effect of voxelotor on markers of cerebral perfusion, cerebral oxygen metabolism, and markers of cardiac stress in SCD patients. Cerebral hemodynamics and oxygen metabolism were measured with MRI before and after 3 months of voxelotor treatment (1500 mg/day) in 18 adults with SCD (HbSS/HbSβ0-thalassemia). Hemoglobin levels significantly increased (p = .001) and markers of hemolysis decreased (p < .05). OD increased from 6.5 (IQR, 6.0-7.1) mL O2/100 g/min to 8.1 (IQR, 7.2-8.7) mL O2/100 g/min (p = .001). CBF and CVR did not change. CMRO2 decreased from 2.0 (IQR, 1.9-2.1) mL O2/100 g/min to 1.9 (IQR, 1.6-2.1) mL O2/100 g/min (p = .03). N-terminal pro-B type natriuretic peptide (NT-proBNP) levels decreased (p = .048) and maximum tricuspid regurgitation flow velocity (TRVmax) normalized in all but one patient with increased TRVmax. Voxelotor treatment in patients with severe SCD did not decrease CBF despite increased Hb levels. Cerebral oxygen metabolism slightly decreased, despite raised OD, most likely due to drug-induced increase in oxygen binding. Nonetheless, voxelotor improved clinically validated markers of cardiac stress.

Enhancing Hemoglobin Levels and Macro-Micronutrient Intake Through the Well-Being Workshop of First 8000 Days of Life

Introduction: Chronic malnutrition is a major source of concern in the malnutrition community. Addressing nutritional needs that are inappropriate for pre-conception adolescents in the first 8000 days of life is a trigger for anemia and stunting in children later in life. The authors developed The Well-Being Workshop of First 8000 Days of Life. This study compared the hemoglobin levels and macro-micro nutrient intake of female adolescents before and after the well-being workshop of first 8000 days of life and their assistance. Methods: An experimental design, within group method, with an equivalent time series design, and 3 times interventions were carried out. A hundred female adolescents aged 14-19 years Yogyakarta city were assigned to this study. All respondents underwent a pretest and posttest before and after being given interventions of well-being workshop. On completion of the three times workshop, blood sampling of haemoglobin level and food record were collected analyzed. In total, the data was collected 3 times after each workshop was held. The data generated was processed using a paired t test. Results: The average hemoglobin level in female adolescents has increased from the first to the fourth examination, with a standard limit value (&gt; 12.0 gr/dL), but the average of macro and micronutrients intake, as assessed using the Nutrisurvey, is below the standard threshold value. A paired T-test revealed a significant difference within the increase in Hb levels on all examinations. The analysis of macronutrients showed that only fiber had a significant difference before and after a series of well-being workshops of first 8000 days of life interventions, i.e. the first and second examinations. Meanwhile the micronutrient analysis, only iron and zinc there were significant differences before and after being given a series of workshops. Conclusions: "The well-being workshops of first 8000 days of life" can be considered in changing the eating behavior of female adolescents to increase hemoglobin levels.

Safety and efficacy of pegcetacoplan treatment for cold agglutinin disease and warm antibody autoimmune hemolytic anemia

Cold agglutinin disease (CAD) and warm antibody autoimmune hemolytic anemia (wAIHA) are rare autoimmune hemolytic anemias characterized by red blood cell destruction, largely attributable to complement activation resulting in intravascular and extravascular hemolysis. Pegcetacoplan is a subcutaneously administered C3-targeted therapy, which may be suitable for treating CAD and wAIHA. In this open-label phase 2 study, analyses were conducted in two cohorts, one for patients with CAD and the other wAIHA. In each cohort, patients were randomly assigned to receive 270 or 360 mg/day pegcetacoplan for up to 48 weeks. Safety endpoints included the incidence and severity of treatment-emergent adverse events (TEAEs) and adverse events of special interest (AESI). Efficacy endpoints included change from baseline in hemoglobin (Hb), lactate dehydrogenase, absolute reticulocyte count, haptoglobin, indirect bilirubin, and Functional Assessment of Chronic Illness Therapy (FACIT)-fatigue scale. Thirteen (100%) and 10 out of 11 (91%) patients with CAD and wAIHA respectively experienced at least 1 TEAE. Ten patients had at least 1 serious adverse event; none were considered related to pegcetacoplan. The only treatment-related AESIs were injection site reactions. Pegcetacoplan increased Hb levels, reduced hemolysis, and increased FACIT-fatigue scale scores in the first weeks; at week 48 the median (interquartile range) change from baseline Hb for the CAD and wAIHA total groups was 2.4 (0.90 to 3.00) and 1.7 g/dL (-1.40 to 2.90), respectively, and improvements in hemolysis and FACIT-fatigue scale scores were maintained. This study demonstrated that pegcetacoplan is generally well tolerated and suggests it can be effective in patients with CAD and wAIHA. Registered at www.clinicaltrials.gov (NCT03226678).

Retrospective Analysis of Factors Influencing the Hemoglobin Level-increasing Effect of Sodium-glucose Co-transporter-2 Inhibitors.

In several studies, Sodium-glucose co-transporter-2 inhibitors (SGLT2i) have been reported to increase hemoglobin (Hb) levels. In a study in which Hb levels were compared between patients who received SGLT2i and dipeptidyl peptidase-4 inhibitors, some patients exhibited increased Hb levels (>1.0 g/dl), whereas some exhibited unchanged Hb levels. Notably, several factors may influence the Hb-increasing effect of SGLT2i. This study aimed to analyze the factors influencing the Hb-increasing effect of SGLT2i. Type 2 diabetes patients were divided into three groups: SGLT2i (SGLT2i only group, n=36), those receiving a combination of SGLT2i and angiotensin-converting enzyme inhibitors (ACEi) or angiotensin receptor blockers (ARBs) (SGLT2i+ACEi/ARBs group, n=32), and those not receiving these drugs (control group, n=49). We retrospectively analyzed Hb changes in these groups. Kaplan-Meier curves compared Hb changes from SGLT2i initiation to day 63, with an Hb increase defined as ≥0.5 g/dl. In addition, sex, age, ACEi/ARBs, estimated glomerular filtration rate, and hematocrit levels were analyzed using Cox proportional hazards as factors influencing Hb-increasing events. Hb-increasing event rates were 61%, 41%, and 20% in the SGLT2i only, SGLT2i+ACEi/ARBs, and control groups, respectively. The Kaplan-Meier curves showed significantly higher Hb-increasing event rates in the SGLT2i only group than in the control and SGLT2i+ACEi/ARBs groups. In the Cox proportional hazards model, ACEi/ARBs use was associated with a 39% reduction in the incidence of Hb-increasing events. SGLT2i exhibit a Hb-increasing effect, which may be reduced by ACEi/ARBs.

THE EFFECT OF SPINACH CONSUMPTION ON INCREASING HAEMOGLOBIN IN PREGNANT WOMEN

Background: Anemia is a symptom of a lack of red blood cells due to low hemoglobin levels. Based on the performance assessment report of the Tuban Regency Senori Community Health Center East Java Indonesia in 2022, it was found that 36.65% of pregnant women experienced anemia. This shows that there are still many pregnant women who experience anemia and need treatment. The aim of this research is to determine the effect of spinach consumption on increasing hemoglobin levels in pregnant women. Method: quasi experiment with One Group Pretest-Posttest design. The sample in this study was 16 pregnant women with anemia in the Senori Community Health Center Tuban Regency East Java Indonesia, who met the inclusion criteria. The research instrument used an observation sheet to determine hemoglobin levels in the blood before and after consuming green spinach, an easy touch Hb level check tool. Data were analyzed using paired T-test. Result : The average Hb level of pregnant women before the intervention was 10.20 gr% and after the intervention was 11.18 gr%, the results of the paired t-test showed a significance value = 0.000, so the significance value (2-tailed) &lt; α (0 .05) which shows that there is an effect of spinach consumption on increasing hemoglobin levels in pregnant women. Conclusion : There is an effect of spinach consumption on increasing Hb levels in pregnant women. Integrated ANC activities are expected to be carried out routinely so that pregnant women who experience anemia can be detected early and health workers can provide explanations to pregnant women about the dangers of anemia during pregnancy and the consumption of spinach and its benefits.

Efficacy and safety of thalidomide in patients with β-thalassemia intermedia and major.

To investigate the short-term and long-term efficacy and safety of thalidomide in the treatment of intermediate and severe β-thalassemia. We analyzed patients with intermediate and severe β-thalassemia treated at our hospital from February 2019 to February 2024. Patients who received treatment for more than 3 months were included. The efficacy of thalidomide was assessed by comparing changes in hemoglobin (Hb), ferritin, bilirubin, and Hb electrophoresis before and after treatment. Adverse drug reactions during treatment were also recorded. A total of 42 β-thalassemia patients were included, with thalidomide dosages ranging from 75 to 150 mg/d. The response rates at 1, 3, and 6 months of treatment were 73.8% (31/42), 75.0% (24/32), and 94.7% (18/19), respectively. The increase in Hb levels was primarily attributed to fetal hemoglobin (HbF). After 1 month of treatment, the HbF percentage increased from a baseline of 34.04 ± 27.58% to 56.25 ± 28.40% (P < .001). At 3 and 6 months, HbF further increased to 67.21 ± 27.12% (P < .001) and 73.93 ± 22.96% (P < .001), respectively. The average duration of thalidomide treatment was 25.3 ± 9.2 months (range: 4-60 months), with 6 patients treated for over 60 months and 18 patients for over 48 months. Two homozygous patients who failed thalidomide treatment achieved Hb levels above 100 g/L and discontinued transfusion therapy after 3 months of hydroxyurea treatment. The most common adverse reaction was somnolence, which was mild and tolerable. Thalidomide demonstrates significant and sustained therapeutic effects in β-thalassemia patients. The adverse reactions are mild and tolerable, allowing patients to continue treatment.

Pengaruh Pemberian Jus Buah Naga terhadap Perubahan Kadar Hemoglobin Ibu Hamil di Wilayah Kerja Puskesmas Kota Baru Kabupaten Indragiri Hilir

The prevalence of iron deficiency anemia in pregnancy is around 95% due to iron deficiency (iron deficiency anemia). Anemia is the second main cause of maternal death, accounting for around 12.8% of maternal deaths due to postpartum hemorrhage. One way to overcome anemia in pregnancy is to consume dragon fruit regularly, in addition to consuming Fe tablets that have been given by midwives or health workers. Giving dragon fruit juice is effective in increasing Hb levels in pregnant women. The research design used in this study was a pre-test and post-test with control group design in the Kota Baru Health Center Working Area, Indragiri Hilir Regency. A population of 230 pregnant women with a sampling technique using simple random sampling obtained 32 respondents (16 intervention groups and 16 control groups). Data analysis used the independent t-test. The results of this study indicate that there is an effect of giving dragon fruit juice on changes in hemoglobin levels of pregnant women in the Kota Baru Health Center Working Area, Indragiri Hilir Regency. Dragon fruit can be used as a supplement to increase hemoglobin levels in pregnant women to treat anemia.

Pil-Pintar Intervention Reduce Anemia among Young Teen Girls: A Pilot Study

Background: Iron deficiency anemia and low adherence to take iron tablets are prevalent issues among teenage school girls in Indonesia. To address this concern and encourage regular iron supplementation, the public health office of Sukoharjo Central Java Indonesia introduced a pil-pintar program, colloquially known as the “smart pill.” Aims: This study aimed to measure the increase in hemoglobin (Hb) levels and its correlation with nutrient intake related to Hb synthesis following the pil-pintar intervention. Methods: A quasi-experimental design with a one-group pre-posttest approach was performed involving 49 school teenage girls aged 12-15 years in a public school in Sukoharjo, Indonesia. Each student was given an iron sugar coat tablet containing 182 mg of ferrous-fumarate (equivalent to 60 mg elemental iron) and 0.400 mg of folic acid per tablet, called pil-pintar, once a week for 12 weeks. Results: A decrease in anemia prevalence by 24.4% and a notable increase in Hb levels by 1.0 mg/dL (p = 0.001) were observed in the 12 weeks of intervention. However, the study found no association between the nutrient intakes related to Hb production and the resulting Hb levels. Conclusion: The pil-pintar program effectively improved the hemoglobin levels of anemic teenage girls in the Sukoharjo district, Indonesia.

Efektifitas Komsumsi Tablet Fe dengan Air Jeruk Nipis terhadap Peningkatan Kadar HB Ibu Hamil Anemia Ringan Trimester III

Background: Anemia is a body condition where the hemoglobin level in red blood cells is lower than the normal standard. Pregnant women are said to be anemic if their Hb content is &lt;11gr/dL. According to WHO, the prevalence of pregnant women throughout the world who experience anemia is 41.8%. The percentage of anemia in pregnant women in Indonesia is 37.1%. For the Special Region of Yogyakarta, the prevalence in pregnant women is 19.01%, and the highest incidence of anemia is in Bantul Regency (27.67%). Data from the Bantul District Health Service, from 27 Community Health Centers, there are 5 Community Health Centers with the highest number of anemia, namely at Sewon II Community Health Center. From this data, Sewon II Community Health Center is in second place. Objective: To determine the effectiveness of consuming fe tablets with lime juice on increasing Hb levels in mildly anemic pregnant women at the Sewon II Bantul Community Health Center, Yogyakarta. Method: This quasi-experiment research uses a one group pretest-posttest design. The sample in the study consisted of 30 pregnant women. The sampling technique uses total sampling. The research instrument gave lime to pregnant women with mild anemia for 2 weeks. Then the hemoglobin level was checked before and after drinking lime using a hemoglobin meter checking device in collaboration with the Puskesmas lab section. Results: The results of this research are based on univariate analysis of the characteristics of respondents aged 20-35 years as many as 26 (86.3%) respondents, the majority have a high school education as many as 26 (86.7%) respondents, the occupation of respondents is housewives 28 (93.3%) ) respondents. The results of the bivariate analysis showed that there was a significant effect on the average value of increasing hemoglobin levels before (10.21) and after drinking lime (11.23) with an average of (1.02). Conclusion: Based on the research results, it can be concluded that there is an effect of giving lime juice on hemoglobin levels in pregnant women in the second trimester at the Sewon II Bantul Community Health Center.

Impact of Iron Tablet and Moringa Leaf Capsule Supplementation on Hemoglobin Levels in Anemic Pregnant Women in Pariaman City, 2016

Background: Iron deficiency anemia is a prevalent global nutritional problem, particularly affecting pregnant women in developing countries. This study aimed to evaluate the effects of iron tablet supplementation and Moringa leaf capsules on hemoglobin (Hb) levels in anemic pregnant women in Pariaman City, Indonesia. Method: A total of 60 pregnant women were divided into two groups: one receiving iron tablets and the other Moringa leaf capsules for four weeks. Hemoglobin levels were measured before and after the intervention. Findings: In the iron supplementation group, the average Hb level increased from 9.05 g/dL to 9.46 g/dL, with a significant improvement (p = 0.001). Similarly, the Moringa capsule group showed an Hb increase from 8.99 g/dL to 9.27 g/dL (p = 0.019). While iron tablets resulted in a greater increase in Hb, Moringa capsules, rich in natural iron, also demonstrated significant effectiveness. The study concludes that both iron supplements and Moringa capsules are effective in increasing Hb levels, with Moringa capsules being a potential natural alternative for combating anemia in pregnant women. However, optimizing the dosage of Moringa could further enhance its efficacy. Factors such as adherence, diet, and knowledge of iron absorption enhancers and inhibitors play crucial roles in the success of the interventions.

Effectiveness of Giving Red Guava Juice and Mung Bean on Hemoglobin Levels Among Post-Partum Mothers with Anemia

Aims: to determine the effectiveness of giving red guava juice and mung bean porridge to increase HB levels in postpartum women with anemia. Methods : The study was quasi-experimental, with a pretest-posttest design for two groups. The sample for this study consisted of all postpartum women who developed anemia between June and July 2023 at the Cikampek Health Center, which may be up to 40 participants. The sampling approach is complete sampling. Results : The red guava juice intervention group had an average HB level of 10.220 gr/dl pre-test and 12.460 gr/dl post-test. The green bean porridge intervention group had an average HB level of 10.230 gr/dl before testing and 12.440 gr/dl after testing. Giving red guava juice and mung bean porridge can successfully improve Hb levels in anemic postpartum women (p-value = 0.000). Conclusions : Red guava juice and mung bean porridge can significantly boost Hb levels in anemic postpartum women. It is believed that postpartum women who have anemia will take red guava juice and mung bean porridge as an alternative to prevent anemia.

The Relationship of PCLR Therapy on Hemoglobin Levels in Anemia Patients at BDRS MMC Jakarta (January-April 2022)

Anemia is generally characterized by a decrease in hemoglobin levels. In terms of function, a decrease in hemoglobin causes a reduction in the body's need for oxygen in sufficient quantities. PCLR (Packed Red Cell Leukoreduced) is a concentrated red blood cell product obtained through the process of reducing leukocytes, so PCLR transfusion is expected to increase Hb levels in anemia patients. This study aims to determine the relationship between PCLR administration and hemoglobin levels in anemia patients and to determine the increase in hemoglobin levels after PCLR transfusion at MMC Hospital Blood Bank (BDRS MMC) Jakarta. Quantitative (analytical) research methods. The sample in this study was 140 data from anemia patients who underwent PCLR transfusion (January-April 2022). Data analysis was carried out univariate and bivariate. The research was carried out at MMC Jakarta Hospital in July 2022. Research results: the majority of patients were elderly (56-&lt;65 years) 67 people (47.9%), the majority gender was female 82 people (58.6%); there was an increase in Hb levels after PCLR transfusion, namely 1.89 gr/dL with an average use of 2 bags; and there is a relationship between PCLR administration and hemoglobin levels in anemia patients at BDRS MMC Jakarta. Suggestion: to achieve an increase in hemoglobin in anemia patients, PCLR can be used as a blood component of choice for transfusion at the right dose.

The Effect Of Delaying Umbilical Cord Cutting On Hemoglobin Levels In Newborn Babies

AbstractIron deficiency anemia, commonly occurring in infants aged 6-24 months, can be prevented by delaying the cutting of the umbilical cord after birth. A quasi-experimental study conducted at the Mother and Child Clinic in Mojo Kediri involved 30 infants, divided into an experimental group (with delayed cord clamping) and a control group. Hemoglobin levels were measured using a Hematology Autoanalyzer, and the data were analyzed using a t-test. The intervention group, with a delay in cord clamping for 1 hour, showed an average increase in Hb levels from 15.444 g/dl to 19.800 g/dl after 24 hours. Meanwhile, the control group, without any delay, increased from 15.544 g/dl to 16.844 g/dl. Delaying the umbilical cord clamping significantly increased hemoglobin levels in newborns (p-value: 0.000). Infants with delayed cord clamping exhibited higher hemoglobin levels, better body iron reserves, and reduced risk of anemia. The higher red blood cell levels supported better cardiopulmonary adaptation and increased breastfeeding duration in early life. The research concludes that delaying the cutting of the umbilical cord for 2 minutes in newborns can enhance Hb levels after 24 hours compared to cord clamping at 15 seconds after birth. This highlights the importance of delaying cord clamping to support hemoglobin health and infant development.Keywords: Delaying Umbilical Cord Clamping, Hemoglobin Levels, Newborns

Perbandingan Pemberian Pisang Ambon Dan Buah Naga Terhadap Kadar Hb Ibu Hamil Di PMB DNP Kecamatan Sukadiri Kabupaten Tangerang

Introduction: The prevalence of anemia in pregnant women is still high. PMB DNP Sukadiri District, Tangerang Regency, pregnant women in their third trimester who experience anemia each year have increased from 2020-2022 namely 13,2% to 15,8%. The government has tried to prevent it by giving Fe tablets and consuming foods containing iron, including Ambon banana and dragon fruit. Objective: Knowing the comparison of giving Ambon bananas and dragon fruit to Hb levels of pregnant women in PMB DNP, Sukadiri District, Tangerang Regency. Methods: Quasi-experimental design with pretest-posttest design with control group design. The sample is pregnant women who experience anemia in January-February 2023 as many as 34 samples using a purposive sampling technique. The intervention was given 250gr once a day for 14 days. Bivariate analysis used paired sample t-tests and independent t-tests. Results: The univariate study of Hb levels of pregnant women before the administration of Ambon bananas averaged = 9,635gr/dl and after the administration of Ambon bananas averaged = 12,118gr/dl. Hb levels of pregnant women before the administration of dragon fruit juice average = 9,641gr/dl and after the administration of dragon fruit juice average = 11,447gr/dl. The results of the bivariate study obtained a p-value = 0,001. Discussion: There are differences in the effect of giving Ambon bananas and dragon fruit juice on Hb levels of pregnant women. Pregnant women are expected to be diligent in consuming foods containing iron, including Ambon banana and dragon fruit, to increase Hb levels in the mother's blood.

Clinical efficacy of thalidomide for various genotypes of beta thalassemia

ObjectiveThe objective of this study was to investigate the therapeutic efficacy of thalidomide across various genotype presentations of β-thalassemia so as to facilitate the early screening of thalidomide-sensitive thalassemia cases and to understand the impact of iron overload on thalidomide.MethodsFrom our initial sample of 52 patients, we observed 48 patients with β-thalassemia for two years after administration of thalidomide. This cohort included 34 patients with transfusion-dependent thalassemia (TDT) and 14 patients with non-transfusion-dependent thalassemia (NTDT). We recorded the values of hemoglobin (Hb), fetal hemoglobin (HbF), and serum ferritin (SF) in the baseline period and at 1, 3, 6, 12, 18, and 24 months after enrollment, as well as the pre- and post-treatment blood transfusion volume in all 48 cases. According to the increase in Hb levels from baseline during the 6-month observation period, the response to thalidomide was divided into four levels: main response (MaR), minor response (MiR), slow response (SLR), and no response (NR). A decrease in serum ferritin levels compared to baseline was considered alleviation of iron overload. We calculated the overall response rate (ORR) as follows: ORR = MaR + MiR + SLR/number of observed cases.ResultsThe ORR was 91.7% (44/48 cases), and 72.9% showed MaR (35/48 cases). Among the 34 patients with TDT, 21 patients (61.8%) were free of blood transfusion, and the remaining 13 patients still required blood transfusion, but their total blood transfusion volume reduced by 31.3% when compared to the baseline. We found a total of 33 cases with 10 combinations of advantageous genes, which included 5 cases with βCD41-42/βCD17 and 6 cases with βCD41-42/β-28. Based on the treatment outcomes among the 48 cases in the observation group, there were 33 cases in the MaR group and 15 cases in the SLR/NR group. There was a difference in HbF between the two groups at baseline (P = 0.041). There were significant differences between the two groups in Hb and HbF at the time points of 6 and 12 months, respectively (P < 0.001). Compared to the baseline measurement, there was a significant decrease in the level of SF at months 12 and 24 (P < 0.001).ConclusionIn this study, we identified 10 β-thalassemia gene combinations that were sensitive to thalidomide. These gene combinations can be used for initial screening and to predict the therapeutic effect of thalidomide in clinical practice. We examined the therapeutic response to thalidomide and found that the administration of thalidomide in combination with standardized iron removal was more beneficial in reducing iron overload.

Regular Consumption of Iron Tablets With Anemia in Pregnant Mothers

Pregnant mothers are one of the groups vulnerable to malnutrition, as there is an increased nutritional need to meet the needs of the mother and the conceived fetus. During pregnancy, the benefits of taking iron tablets or Fe regularly can increase Hb levels so that pregnant mothers do not subsequently have anaemia and can prevent the occurrence of bleeding at the time of delivery, but there are still many pregnant women who are irregular in taking iron pills up to at least 90 tablets. Objective: This study aims to find out the link between regular consumption of iron tablets and the incidence of anaemia in pregnant women in the village of Margorejo. Methods: The type of surveillance used is analytical observational with a Crosectional approach. The population in this study is a pregnant woman of the third trimester in the village of Margorejo. The sample was taken using a saturated sampling method of 30 respondents. The data analysis used is a know-control correlation test. Results: Research results show that the correlation value is 0.541 and the p-value is 0.015 with a significant value of α 0.05. Conclusion: there is a link between regular consumption of iron tablets and anaemia in pregnant mothers

Replacement of the massive amino acid losses induced by hemodialysis: A new treatment option proposal for a largely underestimated issue

BackgroundA series of interesting literature reports acknowledges the notable loss of essential and non-essential amino acids (EAAs and NEAAs) during hemodialysis sessions. These losses may exceed 800 g/year, thus contributing towards accelerating the onset of malnutrition in hemodialysis patients (HD). ObjectiveA novel tailored amino acid formula for oral administration was developed to replace total amounts of each individual amino acid lost during dialysis diffusive/convective HD strategies, monitoring the effects produced on nutritional and hematological status. MethodsA three-month randomized double-blind study was conducted on 30 subjects over the age of 70 years extrapolated from a total population of 86 hemodialysis patients. The 30 patients were randomly assigned to two groups: a treatment group of 15 HD patients (TG) to whom a novel mixture containing 5.4 g of AAs was administered solely on interdialytic days, and a control group of 15 HD patients (CG) who received no amino acid supplementation. The AAs mixture was administered post-dialysis at an extended interval from the end of solute and compartmental rebound to replace AA losses and optimize their role in protein anabolism. ResultsThe results obtained highlighted a significant improvement in protein intake g/kg/day (Protein Catabolic Rate, p= 0.014), and increased IgG (p=0.008) and C3 serum levels (p=0.003) in the TG group alone. Fat mass losses were initially confirmed by means of bioelectrical impedance analysis (BIA) (p=0.011) and plicometry (p<0.001) in the CG group alone, although the main objective was to preserve nutritional status and, particularly, muscle mass. The study was extended to investigate the effects produced on anemia, yielding evidence of continued positive effects three months after the end of the study in the TG group alone based on an increase in Hb levels from 11.2+0.6 to 12.1+0.6 (p=0.004) associated with a reduced demand for erythropoietin i.v. from 12928+9033 to 9286+ 5398 U.I/week (p=0.012) and iron i.v. from 75.9+55 to 71.4+33.4 mg/week (p=0.045). ConclusionsThe results obtained following oral administration of this novel tailored AA replacement mixture aimed at reinstating the high AA losses produced during hemodialysis suggest the mixture should be prescribed as a standard procedure to all HD patients.

Comparative Analysis of Real-World Efficacy and Safety of Hypoxia-Inducible Factor Prolyl-Hydroxylase Inhibitors in Kidney Transplant Recipients Versus Nontransplant Individuals: A Single-Center Study

ObjectivesTo compare the efficacy and safety of hypoxia-inducible factor prolyl-hydroxylase inhibitors (HIF-PHis), a novel agent for management of anemia in chronic kidney disease (CKD), between transplant recipients and nontransplant individuals. MethodsA retrospective analysis was conducted on nondialysis-dependent CKD stage 3 to 5 patients treated with the HIF-PHi roxadustat or daprodustat at a single institution. Patients were categorized as kidney transplant recipients (KTRs) and non-KTRs. Efficacy outcomes (hemoglobin and creatinine levels) and safety profiles (rate of adverse events [AEs], descriptions, and discontinuations due to AEs) were assessed 3 months before and 6 months after HIF-PHi initiation within and then between the groups. ResultsThe study comprised 82 patients (KTR: 43, non-KTR: 39). Median ages significantly differed between the KTR (52.7 years) and non-KTR (82.9 years) groups (P < .001). Roxadustat was predominantly used in the KTR group (88.4%), while daprodustat was used in the non-KTR group (94.9%, P < .001). Both groups exhibited significant increases in Hb levels at 1, 3, and 6 months post-HIF-PHi initiation (P for trend, <.001), with a relative increase in Hb level at 6 months of 16% for KTRs and 13% for non-KTRs. Creatinine levels showed no significant changes over 6 months. Although no difference was observed in drug discontinuation due to AEs, the KTR group experienced a significantly higher rate of thrombotic events (18.6 vs 2.6%, P = .049). ConclusionsHIF-PHis demonstrate comparable efficacy for managing anemia in CKD, regardless of transplant status. However, heightened vigilance for thrombosis events is necessary during follow-up for KTRs.

The effect of giving sweet potato leaf-based functional drink to increase HB levels

BeckgroundMenstruating young women experience twice as much iron loss as young men. One alternative effort that can be made is to provide functional drinks that are useful for overcoming anemia. Functional beverages must provide nutritional intake and sensory satisfaction, such as good taste and good texture, using sweet potato leaves (Ipomoea Batatas L). Sweet potato leaves are chosen as raw material because, besides being abundantly available and accessible to cultivate, they are also very cheap, so that they can reduce production costs. Pancalang Health Center is one of the Health Centers in the Kuningan Regency Area with reasonably high sweet potato cultivation. AimsThis study aims to determine the level of compliance with functional drink consumption, determine hemoglobin levels before and after functional drink intervention, describe anemia status before and after functional drink intervention, describe the effects of functional drink consumption, and nutritional status picture before and after consuming functional drink products. Research methodeThe study was conducted by quasi-experiment in one group (nonrandomized pre-test and post-test without control group design). Purposive sampling was carried out by Purposive Sampling on adolescents at the Pancalang Health Center, Kuningan Regency. Data collection was done by checking HB levels before the intervention and after the intervention. The intervention is carried out for 52 days. Resultsand Conclussion: The majority of respondents were compliant in consuming functional drinks, and only 7.5 % were non-compliant. The median before the intervention is 11 and after the intervention is 12 and a p value of <0,001 is obtained, meaning that statistically there is a significant difference between HB before the intervention and after the intervention. ContributionThere was a significant difference between Hb levels before the intervention and after the intervention, obtaining a p-value of <0.001.

Perbandingan Pemberian Buah Naga Dan Buah Bit Terhadap Kadar Hb Ibu Hamil Di PMB RY Kecamatan Panongan Kabupaten Tangerang

Introduction: Anemia is a factor in maternal mortality. PMB RY Panongan District, Tangerang Regency, the target data for anemic pregnant women in 2020 is 13.6%; in 2021 it is 14.6% and in 2022 it is 15.8%. Prevention of anemia in pregnancy apart from Fe supplements can also be done by consuming foods that contain iron, such as dragon fruit and beets. Methods: Quasi-experimental design with pretest-posttest design with control group design. The sample is pregnant women who experience anemia in January-February 2023 as many as 30 samples using a purposive sampling technique. The intervention was given 250g once a day for 14 days. Bivariate analysis used paired sample t-test and independent t-test. Results: The results of a Univariate study of Hb levels of pregnant women before the administration of dragon fruit averaged = 10,247 gr/dl and after the administration of dragon fruit averaged = 10,627 gr/dl. Hb levels of pregnant women before the administration of beets averaged = 10,187 gr/dl and after the administration of beets averaged = 11,133 gr/dl. The results of the bivariate study obtained a p-value = 0,000. Discussion: There are differences in the effect of giving dragon fruit and beetroot on Hb levels of pregnant women. Pregnant women are expected to be diligent in consuming foods that contain iron, one of which is beetroot and lemon juice, and be obedient in consuming Fe tablets to increase Hb levels in the mother's blood.