A 2006 change in Medicare policy allowed reimbursement for erythropoietin (EPO) in dialysis patients whose most recent hemoglobin exceeded 13 g/dl. We investigated the effects of a change in dosing algorithm implemented in response to this policy, in which EPO dosages were reduced instead of temporarily discontinued for hemoglobin levels > or =13 g/dl. Among 1688 individuals in 18 hemodialysis units, the reduction protocol resulted in more hemoglobin levels > or =13 g/dl (P < 0.0001), fewer levels between 11 and 12.9 g/dl (P < or = 0.004), no difference in the proportion of levels <11 g/dl, and more EPO administered per session (P < 0.0001) than the discontinuation protocol. In view of the expense of erythropoiesis stimulating agents and the uncertainty of the safety of using EPO to achieve high hemoglobin targets, this study suggests that discontinuation, rather than reduction, of EPO treatment is appropriate when hemoglobin reaches 13 g/dl in hemodialysis patients.
Download full-text PDF |
Source |
---|---|
http://dx.doi.org/10.1681/ASN.2007040477 | DOI Listing |
Am J Case Rep
December 2024
Department of General Medicine, Saga University Hospital, Saga, Japan.
BACKGROUND Appropriate management of patients who have fallen is crucial for reducing damage and mortality. We report the case of a patient who fell from a seated position, which caused traumatic liver injury, with gastrointestinal symptoms as the primary patient concern. CASE REPORT A woman in her 80s who was living independently fell from a seated position during the daytime.
View Article and Find Full Text PDFScand J Clin Lab Invest
December 2024
Department of Cardiothoracic Surgery, Anaesthesia, Perfusion, and Intensive Care, Skåne University Hospital, Lund, Sweden.
Haemolysis occurring during cardiac surgery with cardiopulmonary bypass (CPB) is assumed to be a risk factor for postoperative acute kidney injury (AKI). Plasma alpha-1 microglobulin (A1M) may have a protective role as haem scavenger. The aim of this study was to evaluate the association between AKI and the degree of haemolysis and the course of A1M concentrations during cardiac surgery, respectively.
View Article and Find Full Text PDFGenet Test Mol Biomarkers
December 2024
SRM Dental College, Bharathi Salai, Chennai, India.
Periodontal disease worsens glycemic control due to the bidirectional link between periodontitis and type 2 diabetes mellitus (T2DM), involving inflammatory markers such as soluble tumor necrosis factor-like weak inducer of apoptosis (sTWEAK), tumor necrosis factor-α (TNF-α), and omentin-1. However, their combined role in T2DM with periodontitis has not been studied. This study aimed to evaluate the levels of these biomarkers in periodontitis patients with T2DM before and after nonsurgical periodontal therapy (NSPT).
View Article and Find Full Text PDFTrop Med Infect Dis
November 2024
School of Health Systems & Public Health, University of Pretoria, Pretoria 0028, South Africa.
Sickle cell disease (SCD) is a prevalent inherited blood disorder, particularly affecting populations in Africa. This review examined the disease's burden, its diverse clinical presentations, and the challenges associated with its management in African settings. Africa bears a significant burden of SCD, with prevalence varying across countries and age groups.
View Article and Find Full Text PDFPediatr Rep
December 2024
Department of Endocrinology, Diabetes Mellitus, Nutrition and Metabolic Disorders, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania.
Background: Insulin pumps coupled with continuous glucose monitoring sensors use algorithms to analyze real-time blood glucose levels. This allows for the suspension of insulin administration before hypoglycemic thresholds are reached or for adaptive tuning in hybrid closed-loop systems. This longitudinal retrospective study aims to analyze real-world glycemic outcomes in a pediatric population transitioning to such devices.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!