Discussion
Anemia ia associated with a more severe impairment of renal function
in this study and other published research.Anemia severity correlates
with thre degree of renal function impairment an there is evidence that
low levels of Hb were associated with accelerated progression of CKD
.Introduction of EPO in therapy to these patients
Reduce transfusion requirements and improve quality of life of these patients .In our study EPO administration resulted in improved GFR in patients with anemia and there are other studies that reporting an improvement in GFR in patients with anemia and there are other studies that reporting an impronement in GFR decline after correcting anemia ith EPO.According with other published data .there was no difference in the progression rate of CKD in patients with higher values of Hb after EPO use，but was a higher rate of adverse events such as myocardial infarction,death ,hospitalization .In our study GFR was higher in patients without disables and without anemia ompared with those who had anemia and diabetes,too.There are other published research which shows that the association of anemia and DM in patients with CKD had been shown to accelerate the progression of CKD, increasing cardiovascular morbidity and mortality ,in association with a poor prognosis of these patients , Anemia associated inflammation contributes to the decline in GFR , anemia secondary to hypoxia , casuaing inflammation and fibrosis and loss of capillaries , In this study , anemia accompanied by inflammation was associated with a significantly higher risk of developing severe renal impairment . Secondary hyperparathyroidism is associated with hyporesponsiveness to EPO therapy and vitamin D deficiency was associated with reduced hemoglobin levels in patients with CKD . In our study the association of anemia with secondary HPT led to a significant decline in GFR within 12 months of morning . The presence of anemia was associated with a greater number of days of hospitalization (p=0.0001) . In a retrospective study demonstrated that patients with low Hb levels had the highest rate of hospitalization and several comorbidities.
Conclusions
Anemia , a frequent feature of CKD , play an important role in progression of renal impairment ,probably due to hypoxia ,especially in combination with other risk factors such as diabetes or inflammation . Thus early identification and correction of anemia is important for slowing the progression of CKD.
Abbreviation
Hb=hemoglobin
OM=diabetes mellitus
CKD=chronic kidney disase
GFR=glomcrular filtration rate
HPT=hyperparathyroidism
EPO=erythropoietin
Reduce transfusion requirements and improve quality of life of these patients .In our study EPO administration resulted in improved GFR in patients with anemia and there are other studies that reporting an improvement in GFR in patients with anemia and there are other studies that reporting an impronement in GFR decline after correcting anemia ith EPO.According with other published data .there was no difference in the progression rate of CKD in patients with higher values of Hb after EPO use，but was a higher rate of adverse events such as myocardial infarction,death ,hospitalization .In our study GFR was higher in patients without disables and without anemia ompared with those who had anemia and diabetes,too.There are other published research which shows that the association of anemia and DM in patients with CKD had been shown to accelerate the progression of CKD, increasing cardiovascular morbidity and mortality ,in association with a poor prognosis of these patients , Anemia associated inflammation contributes to the decline in GFR , anemia secondary to hypoxia , casuaing inflammation and fibrosis and loss of capillaries , In this study , anemia accompanied by inflammation was associated with a significantly higher risk of developing severe renal impairment . Secondary hyperparathyroidism is associated with hyporesponsiveness to EPO therapy and vitamin D deficiency was associated with reduced hemoglobin levels in patients with CKD . In our study the association of anemia with secondary HPT led to a significant decline in GFR within 12 months of morning . The presence of anemia was associated with a greater number of days of hospitalization (p=0.0001) . In a retrospective study demonstrated that patients with low Hb levels had the highest rate of hospitalization and several comorbidities.
Conclusions
Anemia , a frequent feature of CKD , play an important role in progression of renal impairment ,probably due to hypoxia ,especially in combination with other risk factors such as diabetes or inflammation . Thus early identification and correction of anemia is important for slowing the progression of CKD.
Abbreviation
Hb=hemoglobin
OM=diabetes mellitus
CKD=chronic kidney disase
GFR=glomcrular filtration rate
HPT=hyperparathyroidism
EPO=erythropoietin
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