Presence Of Anemia In Patients Research Articles

FADOI survey on chronic kidney disease and anaemia in internal medicine departments of Italian hospitals

The presence of anaemia in patients with chronic kidney disease (CKD) is associated with decreased quality of life, along with increased morbidity, mortality, and hospitalization rates. This, in turn, affects healthcare costs and the utilization of medical resources. The mechanisms involved in anaemia of CKD are diverse and complex. They include reduced production of endogenous erythropoietin (EPO), absolute and/or functional iron deficiency (due to inflammation leading to elevated levels of hepcidin), the diminished response of the bone marrow to EPO due to uraemic toxins, the shortened lifespan of red blood cells (RBC), and deficiencies in vitamin B12 or folic acid. [...]

Structural and functional changes of the heart and electrical disorders in patients with coronary artery disease with concomitant anemia

The aim of the study: to investigate the effect of concomitant anemia on the features of cardiac remodeling and electrical disorders in patients with coronary artery disease (CAD). Materials and methods. In total, 89 patients with CAD, stable angina II–III FC were examined (men – 34, women – 55, age – 69 (61; 72) years). All patients were divided into 2 groups: the main group (n = 44) consisted of patients with CAD and anemia, the comparison group (n = 45) – patients with CAD without iron-deficiency anemia. The results of echocardioscopy and 24-hour ECG (Holter) monitoring were analyzed. Results. Left ventricular (LV) end-diastolic and end-systolic volume were higher in the main group by 24.7 % (U = 60.0; P < 0.05) and 25.9 % (U = 53.5, P < 0.05), respectively; end-diastolic and end-systolic left ventricular index also were higher in the main group by 20.2 % (U = 99.5; P < 0.05) and 34.8 % (U = 98.5; P < 0.05), respectively. There was no statistically significant difference in the types of LV geometry; however, the left ventricular mass index was significantly higher by 12.0 % in patients of the main group (U = 315.5; P < 0.05). The patients of both groups mostly showed diastolic dysfunction type 1, however, in the main group, there was a tendency to increase the number of patients with diastolic dysfunction type 2 and type 3. In patients of the main group, in the active period, there was a decrease in SDNNi by 31.85 % (U = 216; P < 0.05), VLF by 53.79 % (U = 176; P < 0.05); increase in LF by 60.56 % (U = 53; P < 0.05) and SI by 2.14 times (U = 43.5; P < 0.05). The presence of anemia in patients with CAD caused a twofold increase in the risk of autonomic dysfunction (BP = 2.045; 95 % CI 1.084–3.861; P < 0.05), 1.5 times increase in tachycardia episodes (BP = 1.510; 95 % CI 1.047–2.178; P < 0.05) and 2.2 times increase in myocardial ischemia (BP = 2.173; 95 % CI 1.047–4.512; P < 0.05). Conclusions. Concomitant anemia in patients with coronary artery disease adversely affects the structural and geometric properties of the heart, leads to an overall suppression of heart rate variability, increases the sympathetic tone of the autonomic nervous system in daytime period and the stress index, as well as raises the risk of autonomic dysfunction, tachycardia and myocardial ischemia.

The presence of anemia in patients with leg ulcer: laboratory test.

To evaluate the presence of anemia in patients with chronic lower limb ulcers based on profile and hematometric indices. This is a cross-sectional study carried out in a university hospital in Rio de Janeiro. The sample was composed of 64 participants with lower limb ulcers and evolution time greater than 12 weeks. Data was collected between May/2016 and December/2017 from hematological analyses, records from medical records, and wound assessment form. 36 (56.2%) were male; 38 (59.4%) between 60 and 80 years old; 56 (87.5%) with chronic diseases and 52 (81.2%) with venous ulcers. 6 years mean of active ulceration. Anemia was detected in 36 (56.2%), 27 (75%) of which were normochromic and normocytic; 14 (38.8%) had deficiency anemia recorded in their medical chart. The low hemoglobin concentration is recurrent among the participants characterizing an anemia condition, whose profile reveals congruence to the anemia of chronic disease.

The impact of concomitant anemic syndrome on the clinical course of coronary artery disease

The presence of comorbid pathology negatively affects the prognosis of patients with coronary artery disease (CAD). Today it is important to clarify the features of CAD on the background of concomitant anemia and identify the main risk factors for complications to improve the tactics of this category of patients. The aim. To investigate the influence of concomitant anemic syndrome on the clinical course of coronary artery disease, frequency and features of the main cardiovascular events. Materials and methods. The study involved 91 patients with coronary artery disease (42 men and 49 women, age – 70 (49; 93)). All patients were divided into 2 groups: the main group (n = 46) consisted of patients with coronary artery disease with iron-deficiency anemia, the comparison group (n = 45) – patients with coronary artery disease without iron-deficiency anemia. The study of the main cardiovascular events took into account re-hospitalization due to arrhythmic disorders, progression of heart failure (HF), CAD destabilization within the observed period (1 year), as well as death from cardiovascular causes. The data analysis was performed using Statistica 13.0. Results. During the year, 42 non-fatal cardiovascular events were noted in patients of both groups, however in the main group their total number was 30 (67 %) versus 12 (27 %) in the comparison group (χ2 = 13.603; P < 0.05). The presence of concomitant anemia in CAD patients significantly increased the relative risk of re-hospitalizations (RR = 1.9; 95 % CI 1.230–3.112; P < 0.05). Among the reasons for hospitalization in the main group, HF decompensation prevailed – 17 (57 %) patients, unstable angina – 7 (23 %), arrhythmic disorders – 6 (20 %); in the comparison group, among the reasons for re-hospitalization, 7 (57 %) had HF decompensation, 3 (25 %) had unstable angina, and 2 (17 %) cases had arrhythmic disorders. In total, 9 (19.5 %) deaths were recorded in the main group, while in the comparison group 1 (2.2 %) death was recorded during the year (χ2 = 6.995; P < 0.05). The presence of concomitant anemia in patients with CAD increases the risk of fatal outcome by 8.8 times (RR = 8.8; 95 % CI 1.162–66.685; P < 0.05). The presence of moderate anemia in patients with CAD significantly increases the incidence of combined critical events by 39 % during the year of follow-up compared with mild anemia (χ2 = 12.843; P < 0.05). Conclusions. The presence of concomitant anemia is associated with a worsened prognosis for patients having coronary artery disease due to an increased risk of non-fatal cardiovascular events that require re-hospitalization during the year of observation, and an increased incidence of death. Increasing severity of anemia is associated with an increase in the frequency of the combined critical event during 1 year of follow-up.

Assessment of the prevalence of anemia in patients with primary hyperparathyroidism: a single-center observational study

The combination of primary hyperparathyroidism (PHPT) with anemia was first described in 1931. It remains unclear whether PHPT is the direct cause of anemia, or it develops due to PHPT's complications. The frequency of PHPT--associated anemia in the Russian population is unknown. To assess the prevalence of anemia in patients with PHPT admitted to the Department of Parathyroid Glands Pathology in the Endocrinology Research Centre from January 2017 to August 2020. The study included patients with PHPT over 18 years old. A single-center observational one-stage one-sample uncontrolled study was carried out. We analyzed laboratory and instrumental data obtained during inpatient examination in accordance with the standards of medical care. Statistical analysis was performed using Statistica 13 (StatSoft, USA) and SPSS (IBM, USA) software packages. The study included 327 patients with PHPT, 28 (9%) men and 299 (91%) women. The median age was 59 years [51; 66]. 26 patients (8%) with anemia were identified. Statistically significant differences between patients with and without anemia were found only in the GFR. Comparison of patients with and without anemia didn't reveal any significant differences in the incidence of PHPT's complications.Significant differences in serum hemoglobin concentration and average hemoglobin concentration in erythrocytes were revealed between patients with and without vertebrae fractures. In the group of patients without compression fractures these parameters were higher.In the subgroup of patients with total calcium concentration above 3 mmol/L and PTH above 3 normal values, the incidence of anemia reached 21% (95% CI: 10%; 35%). Within this group we revealed tendencies to higher levels of PTH, ionized calcium and osteocalcin in patients with anemia. In general, there was no correlation between hypercalcemia, the degree of PTH elevation and the presence of anemia in patients with PHPT. However, in the subgroup of patients with severe hypercalcemia, there was a relationship between the concentration of PTH, ionized calcium and the presence of anemia. In patients with PHPT and vertebral fractures, significantly lower concentrations of blood hemoglobin and hemoglobin in erythrocytes were observed.

Оценка распространенности анемий у пациентов с первичным гиперпаратиреозом: одноцентровое обсервационное исследование

BACKGROUND : The combination of primary hyperparathyroidism (PHPT) with anemia was first described in 1931. It remains unclear whether PHPT is the direct cause of anemia, or it develops due to PHPT’s complications. The frequency of PHPT-­associated anemia in the Russian population is unknown. AIM : To assess the prevalence of anemia in patients with PHPT admitted to the Department of Parathyroid Glands Pathology in the Endocrinology Research Centre from January 2017 to August 2020. MATERIALS AND METHODS : The study included patients with PHPT over 18 years old. A single-center observational one-stage one-sample uncontrolled study was carried out. We analyzed laboratory and instrumental data obtained during inpatient examination in accordance with the standards of medical care. Statistical analysis was performed using Statistica 13 (StatSoft, USA) and SPSS (IBM, USA) software packages. RESULTS : The study included 327 patients with PHPT, 28 (9%) men and 299 (91%) women. The median age was 59 years [51; 66]. 26 patients (8%) with anemia were identified. Statistically significant differences between patients with and without anemia were found only in the GFR. Comparison of patients with and without anemia didn’t reveal any significant differences in the incidence of PHPT’s complications. Significant differences in serum hemoglobin concentration and average hemoglobin concentration in erythrocytes were revealed between patients with and without vertebrae fractures. In the group of patients without compression fractures these parameters were higher. In the subgroup of patients with total calcium concentration above 3 mmol/L and PTH above 3 normal values, the incidence of anemia reached 21% (95% CI: 10%; 35%). Within this group we revealed tendencies to higher levels of PTH, ionized calcium and osteocalcin in patients with anemia. CONCLUSION : In general, there was no correlation between hypercalcemia, the degree of PTH elevation and the presence of anemia in patients with PHPT. However, in the subgroup of patients with severe hypercalcemia, there was a relationship between the concentration of PTH, ionized calcium and the presence of anemia. In patients with PHPT and vertebral fractures, significantly lower concentrations of blood hemoglobin and hemoglobin in erythrocytes were observed.

25375 The role of interleukin-6 in anemia associated with hidradenitis suppurativa

Numerous studies have evaluated the presence of anemia in patients with hidradenitis suppurativa (HS), and conflicting findings have characterized this anemia as either anemia of chronic disease (ACD) or iron deficiency anemia (IDA). Patients with HS have immune dysregulation and elevated inflammatory mediators, including interleukin (IL)-6, which have been linked with ACD in other inflammatory conditions. Interleukin-6 induces ferritin transcription and translation, resulting in increased iron storage, as well as stimulation of hepcidin production, resulting in decreased iron absorption and release in the circulation.

Factors Related to the Presence of Anemia in Patients with Chronic Kidney Disease in Hemodialysis

Introduction: The prevalence of anemia in Chronic Kidney Disease (CKD) is high. However, little is known about the factors related to anemia in patients with chronic Hemodialysis (HD) in Mexico. Material and Methods: A cross-sectional study was conducted in adult patients with CKD undergoing HD in the northern area of Mexico City treated at the Mexican Institute of Social Security. Hemoglobin (Hb) and Hematocrit (Htc) levels, as well as clinical and biochemical factors associated with anemia, were evaluated. Results: Data was collected from 747 patients, obtaining a mean hemoglobin of 9.7 g/dl (IQR 8.4-10.9 g/dl). The group was divided into two using Hb <10.0 g/dl and >10.0 g/dl as cutoff limits. Fifty six percent of the patients had hemoglobin =10.0 g/dl. Hb level <10.0 g/dl were associated with DM (OR 1.49, IC 95% 1.06-2.10, p=0.001), hyperphosphatemia (OR 1.69, IC 95% 1.21-2.28, p=0.001), high calcium-phosphate product (OR 1.43, IC 95% 1.01-2.03, p=0.040) and iron deficiency (OR 1.95, IC 95% 1.38-2.75, p=0.001). Glomerulopathies (OR 0.44, IC 95% 0.22-0.90, p=0.026), female gender (OR 0.55, IC 95% 0.40-0.074, p=0.001) and erythropoietin administration (OR 0.57, IC 95% 0.39-0.82, p=0.002) were associated with hemoglobin ≥10 g/dl. Conclusion: The factors associated with Hb <10.0 g/dl were mineral-bone metabolism disorders and iron deficiency. The periodic evaluation of qualityof- care indicators of HD treatment, such anemia, are necessary to detect improvement opportunities.

The Impact of CKD Anaemia on Patients: Incidence, Risk Factors, and Clinical Outcomes-A Systematic Literature Review.

Anaemia is a common consequence of chronic kidney disease (CKD); however, the risk factors for its development and its impact on outcomes have not been well synthesised. Therefore, we undertook a systematic review to fully characterise the risk factors associated with the presence of anaemia in patients with CKD and a contemporary synthesis of the risks of adverse outcomes in patients with CKD and anaemia. We searched MEDLINE, EMBASE, and the Cochrane Library from 2002 until 2018 for studies reporting the incidence or prevalence of anaemia and associated risk factors and/or associations between haemoglobin (Hb) or anaemia and mortality, major adverse cardiac events (MACE), hospitalisation, or CKD progression in adult patients with CKD. Extracted data were summarised as risk factors related to the incidence or prevalence of anaemia or the risk (hazard ratio (HR)) of outcome by Hb level (<10, 10–12, >12 g/dL) in patients not on dialysis and in those receiving dialysis. 191 studies met the predefined inclusion criteria. The risk factor most associated with the prevalence of anaemia was CKD stage, followed by age and sex. Mean HRs (95% CI) for all-cause mortality in patients with CKD on dialysis with Hb <10, 10–12, and >12 g/dL were 1.56 (1.43–1.71), 1.17 (1.09–1.26), and 0.91 (0.87–0.96), respectively. Similar patterns were observed for nondialysis patients and for the risks of hospitalisation, MACE, and CKD progression. This is the first known systematic review to quantify the risk of adverse clinical outcomes based on Hb level in patients with CKD. Anaemia was consistently associated with greater mortality, hospitalisation, MACE, and CKD progression in patients with CKD, and risk increased with anaemia severity. Effective treatments that not only treat the anaemia but also reduce the risk of adverse clinical outcomes are essential to help reduce the burden of anaemia and its management in CKD.

The association of anemia as a risk of heart failure.

Aim:The present study was conducted to assess the presence of anemia in patients with advanced heart failure (HF) and compared the clinical characteristics of patients with anemia and without anemia.Methodology:The present study was conducted on 102 patients (60 males, 42 females) with advanced HF admitted in hospital. In all, general physical and clinical examinations were performed. All were subjected to complete blood count (CBC), hematocrit, and assessment of urea, creatinine, sodium, potassium, and brain natriuretic peptide (BNP). The levels of serum iron, ferritin, iron saturation, and iron-binding capacity were also evaluated. The causes of HF were assessed.Results:Mean age was 48.2 ± 5.7 and 42.2 ± 6.2 years in males and females patients, respectively. Left ventricular ejection fraction (LVEF) was 0.26 ± 0.8 in males and 0.24 ± 0.5 in females. 71.5% males and 76.3% females were on inotropic support. The etiology of HF was ischemia in 29% males and 27% females, high blood pressure in 15% males and 12% females, obesity in 18% males and 19% females, valvular heart disease in 7% males and 5% females, diabetes in 11% males and 6% females, and idiopathy in 20% males and 31% females. There was a significant difference in mean age, initial HB, final HB, hypertension, creatinine, BNP, and initial hematocrit level in patients with anemia and without anemia (P < 0.05). Deaths in hospital were also significant (P < 0.05).Conclusion:Anemia was seen in one-third of the patients with HF. Anemia was an independent marker with poor prognosis. Anemic patients were older than non-anemic patients.

Prevalence of anemia and its correlation with HBA1c of patients in Type-II diabetes mellitus: A pilot study

Background: Decrease in oxygen carrying capacity of the blood due to deficient erythropoietin is the characteristic of chronic kidney disease. Furthermore, the diabetic nephropathy secondary to uncontrolled diabetes mellitus (DM) leads to anemia in patients. Many reports suggest the presence of anemia in patients with diabetes with renal insufficiency while few studies indicating the incidence of anemia in diabetic patients before renal impairment. Aims and Objective: The aims of this study were to find out the prevalence of anemia among patients with Type 2 diabetes with and without renal insufficiency. Materials and Methods: It is a cross-sectional study including 54 Type 2 diabetic patients in 3 months period, visiting the Department of Medicine. Hemoglobin percentage, HbA1c, and serum creatinine were found out after collecting blood. Alcoholic, smokers, patients on hematinic, and liver disease were excluded from the study. All data were analyzed using Epi-info software. Analysis was performed using chi-square test. P values < 0.05 were considered to be statistically significant. Result: The mean age of the study population was 51.39 ± 8.8 years. The overall prevalence of anemia was found to be 67%, which includes 20 patients with renal insufficiency and 34 with normal kidney status, with 70% and 58.8% prevalence of anemia, respectively. There was no statistical significant difference between these two groups (P > 0.05). Anemia was more common in male (66.7%) compared to female (57.1%) diabetic population. Conclusion: Poor glycemic control is related to the prevalence of anemia in patients with DM.

Anemia and the Risk of Life-threatening Ventricular Tachyarrhythmias from the Israeli Implantable Cardioverter Defibrillator Registry

Anemia was shown to be associated with increased risk for adverse events in patients with heart failure (HF). However, there are limited data on the association between anemia and the risk for ventricular arrhythmias (VAs) in patients with an implantable cardioverter defibrillator (ICD). The present study population comprised 2,352 patients who were enrolled and prospectively followed up in the Israeli ICD Registry. The risk for a first appropriate ICD shock for VA was assessed by the presence of anemia, categorized at the lower tertile of hemoglobin distribution (≤12 g/dL [n = 753]). Patients who had anemia displayed higher risk clinical characteristics including older age, more advanced HF symptoms, and atrial fibrillation (p <0.01 for all). Kaplan-Meier survival analysis showed that at 2.5 years of follow-up the rate of appropriate shocks was significantly higher in patients with low (11%) versus high (6%) hemoglobin (log-rank p <0.005). Multivariate analysis showed that anemia was independently associated with a significant 56% increased risk for first appropriate ICD shock (p <0.026). When hemoglobin was assessed as a continuous measure, each 1 g/dL reduction in hemoglobin was independently associated with a significant 8% increased risk for first appropriate shock (p <0.03). Anemia was also associated with increased risk for all-cause mortality (hazard ratio [HR] 1.78, 95% confidence interval [CI] 1.4 to 2.27], p <0.001), HF hospitalizations or death (HR 1.78, 95% CI 1.48 to 1.13, p <0.001), but not with inappropriate ICD shocks (HR 1.24, 95% CI 0.70 to 2.21, p = 0.47). In conclusion, our findings suggest that the presence of anemia in patients with ICD is associated with increased risk for VA during long-term follow-up.

IRON METABOLISM, ERYTHROPOIESIS AND IMMUNE INFLAMMATION IN ANEMIC PATIENTS WITH CHRONIC HEART FAILURE IN THE PRESENCE OF DIABETIC NEPHROPATHY

The development of anemia in patients with chronic heart failure by the presence of diabeticnephropathy is characterized by erythropoietyc activity fall due to the low level of erythropoietinand functional iron deficiency, as a result of influence of pro-inflammatory cytokine level on hepcidinactivity, resulting in the disruption of the functional iron fund, deposited block of iron. The presenceof microalbuminaemia can be considered as a factor in formation of anemic syndrome due to loss oferythropoietin, transferrin, soluble transferring receptor as a part of protein’s pool in patients withchronic heart failure and diabetic nephropathy. The presence of anemia in patients with chronic heartfailure and diabetic nephropathy is associated with inadequate low central regulator of erythropoiesislevel in response to low hemoglobin concentrations on background of moderate decrease in glomerularfiltration rate.

Anemia in Patients with Chronic Obstructive Pulmonary Disease in a Tertiary Care Hospital in Bangladesh

Background: Chronic obstructive pulmonary disease (COPD) is usually associated with polycythemia. It is assumed that systemic inflammatory components of COPD can interfere with erythropoietin and can result in anemia of chronic disease which will impair the functional capacity of these patients and also increase morbidity and mortality. Objective: To evaluate anemia status in COPD patients. Materials and Methods: This cross-sectional study was conducted in clinically stable 50 COPD patients in the outpatient department of Medicine in Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka during the period of July to December 2011. The demographic characteristics, smoking habit, duration of disease, types and severity of anemia, BMI and results of 6-minute walk test were recorded. Results: Out of 50 COPD patients, 76% were male and 24% were female. Among them 32% patients were anemic, 20% were polycythemic and 48% patients had normal hemoglobin. Among the anemic patients with COPD, 87% were male and 13% were female,75% were mildly anemic and 4% moderately anemic, 62.5% had normocytic and 37.5% had microcytic anemia. Conclusion: Anemia in COPD patients is often overlooked and underestimated. Clinicians should be aware of the presence of anemia in patients with COPD so that appropriate treatment could be initiated to improve the quality of life and prognosis DOI: http://dx.doi.org/10.3329/jemc.v4i3.20943 J Enam Med Col 2014; 4(3): 151-155

Impact of Blood Transfusions on Short- and Long-Term Mortality in Patients Who Underwent Transcatheter Aortic Valve Implantation

Baseline anemia is associated with transfusions and increased risk of mortality in patients who underwent cardiac surgery and percutaneous coronary intervention. The impact of blood transfusions in anemic patients who underwent transcatheter aortic valve implantation (TAVI) remains unclear. All patients who underwent transfemoral TAVI at our institution were retrospectively included. We determined the effect of blood transfusions on short- and long-term mortality and its interaction with baseline hemoglobin levels and bleeding complications. Additionally, we evaluated baseline hemoglobin effect on mortality. A total of 332 patients were included. All patients (99%) except 2 (1%) met the definition for anemia. Of the 332 patients, 124 (37%) received a blood transfusion and 208 (63%) did not. Blood transfusions were associated with increased in-hospital (p <0.001), 30-day (p <0.001), and 1-year (28% vs 13%, p= 0.001) mortality; however, after a landmark analysis, the effect of blood transfusion on mortality was only seen within 30days of the procedure (p=0.001). The increased risk of mortality associated with blood transfusion was present after multivariate adjustment at 30days (hazard ratio 3.59 [1.04 to 12.4]; p= 0.04). Major vascular complications were a correlate for short- and long-term death. In contrast, baseline hemoglobin level and bleeding complications were not independently associated with mortality. The p value for interaction was not significant between transfusion and hemoglobin level and for transfusion and bleeding complication and transfusion and major vascular complication. In conclusion, the presence of anemia in patients who underwent TAVI does not affect mortality. Transfusion is a correlate of all-cause mortality in this patient population and should be used with caution.

Association between Severity of Anemia and 30-Day Readmission Rate: Archival Data of 847 Patients with Acute Decompensated Heart Failure

Hospitals today are facing adjustments to reimbursements from excessive readmission rates. One of the most common and expensive causes of readmissions is exacerbation of a heart failure condition. The objective of this paper was to determine if there was an association between the presence of anemia in patients with acute decompensated heart failure and their readmission rate. Using archival data of 4 hospitals in the Miami area, a sample of 847 inpatients with a diagnostic related group (DRG) of HF at discharge was considered. There was a significant association between low hemoglobin values and a high rate of readmissions at 14 days and at 30 days in subjects with normal sodium and creatinine values. For subjects with low sodium and high creatinine values, a higher readmission rate was seen in men with low hemoglobin but not in women. These results support a prospective effort to measure the impact of anemia and its treatment on readmission rates.

Pathophysiology of anemia in chronic kidney diseases: A review

Backgroud. Anemia is one of the laboratory and clinical findings of chronic kidney diseases (CKD). The presence of anemia in patients with CKD has a wide range of clinically important consequences. Some of the symptoms that were previously attributed to reduced renal function are, in fact, a consequence of anemia. Anemia contributes to increased cardiac output, the development of left ventricular hypertrophy, angina, and congestive heart failure. According to current knowledge, anemia also contributes to the progression of CKD and is one of the factors that contribute to the high morbidity and mortality in patients with chronic renal failure and their reduced survival. MEDLINE search was performed to collect both original and review articles addressing anemia in CKD, pathophysiology of renal anemia, erythropoiesis, erythropoietin, iron metabolism, inflammation, malnutrition, drugs, renal replacement therapy and anemia management The present review summarized current knowledge in the field of the pathophysiology of renel anemia. Understanding the pathophysiology of anemia in CKD is crucial for the optimal treatment of anemia according to recent clinical practice guidelines and recommendation, and correct recognition of causes of resistence to treatment of erythropoietin stimulating agents (ESA).

Investıgatıon of malignancy in diabetic patients with anemia

<b>Introduction:</b> The etiology of anemia is multifactorial in diabetes and covers inflammation, diabetes, nutritional deficiencies, autoimmune diseases, medications and hormonal changes, in addition to the kidney diseases or may be malignancy. In this study, it was aimed to study the profile of the malignancy in patients with type 2 diabetes mellitus (DM) and anemia. <b>Materials and Methods:</b> The files of the follow-up patients with type 2 diabetes were retrospectively reviewed and 103 patients with type 2 DM and anemia were included in the study. The demographic, hematological and biochemical analysis of the data was performed in the diabetic patients with anemia. The frequency of malignancy in diabetic patients with anemia, the etiology of malignancy, the relationship between the presence of malignancy and anemia type and depth, biochemical parameters in the determination of malignancy, the effects of endoscopic and imaging methods, the presence of anemia in patients without malignancy and the effect of in-depth glomerular filtration rate were investigated. <b>Results:</b> The iron deficiency anemia (69.9%) was the most common. Malignancy was found in 11 of the 103 patients (10.7%). 2 patients (1.9%) had stomach cancer, 4 patients (6.3%) had colon cancer in endoscopic procedures. In computerized tomography images, 5 patients were found to be malignant in addition to the stomach and colon cancer. The erythrocyte sedimentation rate was significantly higher in the group with malignancy. No correlation was found between malignancy and anemia type and depth. <b>Conclusion:</b> Screening for malignancy should be considered in diabetic patients with anemia, especially in patients with elevated erythrocyte sedimentation rate, regardless of the type and depth of the anemia. In addition, tomography should be recommended for malignancy screening in diabetic patients with anemia that have a normal gastrointestinal examination.

The Role of Treatment for Anemia as a Therapeutic Target in the Management of Chronic Heart Failure: Insights After RED-HF

Anemia is common in patients with heart failure (HF) and appears to be closely linked with HF prognosis. A variety of mechanisms have been implicated in the association between anemia and HF, and treatment of anemia as a therapeutic target in HF patients is gaining increased attention. Recently large randomized controlled trials of erythropoietin-stimulating agents (ESA) and intravenous iron supplementation therapy have been completed and shed light on treatment of anemia in HF patients. ESA therapy did not show improvement in clinical outcomes, but intravenous iron supplementation may be of benefit in improving HF symptoms. Anemia has been commonly reported in patients with chronic heart failure (HF) and its prevalence appears to be closely linked with the severity of HF. Furthermore, the presence of anemia in patients with HF has been consistently associated with poor prognosis. Despite an increasing number of studies evaluating the relationship between HF and anemia, the answer to whether anemia is simply a marker or a mediator of poor prognosis in HF patients remains uncertain. One approach to this pivotal question has been to investigate treatment for anemia as a therapeutic target in HF.

Presence of anemia in patients with celiac disease suggests more severe disease

Most of celiac disease (CeD) patients have anemia, and its diagnosis is seldom considered in the presence of normal hemoglobin. However, over the past few years, we have observed a few CeD patients having normal hemoglobin. Therefore, we reviewed our CeD database to find out what proportion of CeD patients had normal hemoglobin levels and if there were any differences in characteristics of those with and without anemia. Of 338 CeD patients, 14.8 % had normal hemoglobin levels at diagnosis. When compared with CeD patients without anemia, those with anemia had significantly longer duration of symptoms, lower albumin levels, and higher anti-tissue transglutaminase fold rise, and a higher proportion had abnormal d-xylose tests and severe villous abnormalities. Thus, CeD patients with anemia had more severe disease than those without anemia. It is therefore important to diagnose these patients at an earlier stage of the disease even when the classical feature such as anemia is not clinically evident.