Mechanisms of Disease: erythropoietin resistance in patients with both heart and kidney failure.

Mechanisms of Disease: erythropoietin resistance in patients with both heart and kidney failure. Research Abstract Details 

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Mechanisms of Disease: erythropoietin resistance in patients with both heart and kidney failure. Abstract Text:

Karien van der Putten,Branko Braam,Kim E Jie,Carlo Ajm Gaillard,Karien van der Putten,Branko Braam,Kim E Jie,Carlo A J M Gaillard,Karien van der Putten,Branko Braam,Kim E Jie,Carlo A J M Gaillard,

Anemia is common in patients who have both heart failure and chronic kidney disease, and there is an association between anemia and progression of both diseases. The main causes of anemia are deficient production of erythropoietin (EPO), iron deficiency, and chronic disease with endogenous EPO resistance. EPO has been successfully used for over a decade to treat anemia in patients with chronic kidney disease. Less obvious are the safety and efficacy of EPO treatment in patients with both heart failure and renal disease. Up to 10% of patients receiving EPO are hyporesponsive to therapy and require large doses of the agent. Several mechanisms could explain resistance to endogenous and exogenous EPO. Proinflammatory cytokines antagonize the action of EPO by exerting an inhibitory effect on erythroid progenitor cells and by disrupting iron metabolism (a process in which hepcidin has a central role). EPO resistance might also be caused by inflammation, which has a negative effect on EPO receptors. Furthermore, neocytolysis could have a role. As resistance to exogenous EPO is associated with an increased risk of death, it is important to understand how cardiorenal failure affects EPO production and function.

Mechanisms of Disease: erythropoietin resistance in patients with both heart and kidney failure. Publishing Authors By Initials

K van der Putten,B Braam,KE Jie,CA Gaillard,K van der Putten,B Braam,KE Jie,CA Gaillard,K van der Putten,B Braam,KE Jie,CA Gaillard,

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Mechanisms of Disease: erythropoietin resistance in patients with both heart and kidney failure. Journal Published:

PUBLICATION TYPE: Journal Article

Journal: Nature clinical practice. Nephrology

VOLUME: 4

Page Numbers: 47-57

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ISSN: 1745-8331

DAY: 20

MONTH: Jan

YEAR: 2008

Mechanisms of Disease: erythropoietin resistance in patients with both heart and kidney failure. Information

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LANGUAGE: eng

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AFFILIATION: K van der Putten is a Physician and Investigator for the EPOCARES study and CAJM Gaillard is a Nephrologist, in the Department of Internal Medicine, Meander Medical Center, Amersfoort, The Netherlands.

Country: England

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MEDLINETA: Nat Clin Pract Nephrol

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