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Introduction: Parathormone (PTH) and phosphorus, which are considered as uremic toxins, are associated with reduced red cell survival, yet with unproven mechanism. We aimed to assess the relation between PTH and phosphorus levels and eryptosis in patients with CKD5d treated by hemodialysis. Methods: In a cohort of 85 patients with CKD5d treated by conventional hemodialysis, the percent of annexin V‐binding RBCs was assessed by flow cytometry to indicate the percent of eryptotic RBCs. Findings The median percent of annexin V‐binding RBCs was 2.3 (1.4–4.7)%. On linear regression analysis, PTH was independently associated with the percent of annexin V‐binding RBCs (β = 0.003; 95% CI: 0.002–0.004; p < 0.001). The percent of annexin V‐binding RBCs differed significantly in patients with low PTH (<150 pg/mL; 27/85, 31.8%), target PTH (150–600 pg/mL; 32/85, 37.6%), and high PTH (>600 pg/mL; 26/85, 30.6%) groups (1.24 [0.65–1.85]; 2.46 [1.73–4.05]; and 4.82 [3.45–5.61]%, respectively; p < 0.001). Considering the tertiles of the percent of annexin V binding RBCs, PTH increased significantly from 85 (50.6–273) in the 1st to 298.3 (172.8–606.8) in the 2nd and 827.6 (357.4–1171.3) pg/mL in the 3rd tertiles (p < 0.001). Phosphorus and calcium levels as well as the CaxPh product were similar among the three tertiles (p > 0.05). Discussion: Patients with CKD5d express high rates of eryptosis. PTH excess in those patients may result in further eryptosis enhancement, and this represents a potential pathogenic mechanism linking hyperparathyroidism with the anemia of CKD. [ABSTRACT FROM AUTHOR]

Chronic kidney disease is usually related with anemia and the level of anemia correlates with the severity of renal failure. A chronic kidney disease is complicated by anemia and anemia may contribute to adverse clinical outcomes. No large-scale population data are available for patients with chronic kidney disease regarding prevalence of anemia, subpopulations at risk, and relationships between anemia and renal dysfunctionObjectives:The objective of this study is to determine the frequency of different patterns of anemia in relation to glomerular filtration rate in patients suffering from chronic kidney disease stage II and above patients.Material &Methods:Study Design: Cross sectional study. Setting:Medical and Nephrology wards of Liaquat University Hospital Hyderabad / Jamshoro. Period:20th January 2013 to 19thDecember 2013.Results:During the study period, total 339 patients of chronic kidney disease with stage II and above patients were enrolled. The mean age ± Standard Deviation and range) of patients was 50.65 ± 11.86 (16 to 80 years, n = 339). 211(62.2%) were male and 128(37.8%) were female. (Male to Female Ratio 1:6). Mean Hemoglobin ± SD was 7.16 ± 3.89 (3.0 to 17.0 g/dL). The frequency of anemia was present in 285(84.1%) patients with mean Hb± SD 6.02 ± 2.1 (g/dL). The mean weight ± SD was 56.50 ± 9.84 (40 to 81 kg). The mean serum creatinine ± SD was 5.63 ± 2.48 (0.9 to 12.0 mg/dL) and we observed that most frequent pattern of anemia was normocytic-normochromic anemia in 216(77.0%) patients, hypochromic-microcytic in 61(18.0%) and macroyctic in 17(5.0%) patients. We alsofound that as anemia increased progressively with declining GFR with mean hemoglobin concentration of 11.78 ±2.8 g/dL in CKD stage 2, 10.14 ± 3.6 g/dL in CKD stage 3, 6.8 ± 3.6 g/dL in CKD stage 4, 7.44 ± 4.0 g/dL in CKD stage 5.Conclusion: Frequency of anemia increases with the progression of stage of chronic kidney disease (decreased GFR) and anemia was most common in stage 5 patients of chronic kidney disease.Most frequent pattern of anemia is normocytic normochromic anemia. [ABSTRACT FROM AUTHOR]

Background: Chronic kidney disease is a progressive and irreversible loss of renal function. Anemia is one of the main complications of end-stage renal disease (ESRD) which is linked closely with other complications of the disease. The primary therapy for anemia in these patients is erythropoietin (EPO). The goal of this study was to find the effect of Vitamin D administration in addition to the appropriate dose of EPO in ESRD patients with Vitamin D deficiency. Materials and Methods: This was a double-blind clinical trial on 64 ESRD patients undergoing hemodialysis in Amin and Noor Hospitals of Isfahan, Iran. The patients were divided into two groups of control and intervention. The intervention group was given Vitamin D supplements and the control group received placebo. The required dose of EPO to reach the target hemoglobin (Hb) was measured and statistically analyzed. Results: A total number of 32 females and 32 males were included in this study. All the patients in the treatment group were aged between 18 and 76 and the patients in the control group were aged between 21 and 76 years old. There was a significant statistical relationship between Vitamin D administration and the required dose of EPO in both groups (P = 0.013). However, there was no correlation between the concentration of Hb and serum Vitamin D levels. Conclusion: Based on the main finding of this study, the relationship between Vitamin D administration and required dose of EPO seems that the predicted dose of Vitamin D prescribing strategy in Kidney Disease Outcomes Quality Initiative guidelines is not adequate to achieve normal serum Vitamin D in ESRD patients. [ABSTRACT FROM AUTHOR]

Cardiovascular disease (CVD) is the leading cause of death in patients undergoing dialy sis. This article summarizes identified CVD risk factors, elaborates on how risk factors impact patients, and discusses the implications to the nephrology community based on the current evidence-based practice. [ABSTRACT FROM AUTHOR]