Advances on erythropoietin treatment of anemia in prematurity infants / 中华实用儿科临床杂志

Anemia is one of the common complications in preterm infants.Although there are many factors that can cause anemia of prematurity (AOP), erythropoietin (EPO) deficiency is one of the main causes of AOP.Insufficient EPO levels in premature infants and their mechanisms are the hotspots of AOP research at home and abroad.The rational use of EPO for prevention and treatment of AOP has become an international consensus and significant clinical outcomes have been obtained.The recent progress in the field of AOP, the relationship between EPO and AOP, and the clinical application and efficacy of EPO in the prevention and treatment of AOP in recent 3 to 5 years have been reviewed.

Advances on erythropoietin treatment of anemia in prematurity infants / 中华实用儿科临床杂志

Anemia is one of the common complications in preterm infants.Although there are many factors that can cause anemia of prematurity (AOP),erythropoietin (EPO) deficiency is one of the main causes of AOP.Insufficient EPO levels in premature infants and their mechanisms are the hotspots of AOP research at home and abroad.The rational use of EPO for prevention and treatment of AOP has become an international consensus and significant clinical outcomes have been obtained.The recent progress in the field of AOP,the relationship between EPO and AOP,and the clinical application and efficacy of EPO in the prevention and treatment of AOP in recent 3 to 5 years have been reviewed.

Treatment of renal anemia: Erythropoiesis stimulating agents and beyond

Anemia, complicating the course of chronic kidney disease, is a significant parameter, whether interpreted as subjective impairment or an objective prognostic marker. Renal anemia is predominantly due to relative erythropoietin (EPO) deficiency. EPO inhibits apoptosis of erythrocyte precursors. Studies using EPO substitution have shown that increasing hemoglobin (Hb) levels up to 10–11 g/dL is associated with clinical improvement. However, it has not been unequivocally proven that further intensification of erythropoiesis stimulating agent (ESA) therapy actually leads to a comprehensive benefit for the patient, especially as ESAs are potentially associated with increased cerebro-cardiovascular events. Recently, new developments offer interesting options not only via stimulating erythropoeisis but also by employing additional mechanisms. The inhibition of activin, a member of the transforming growth factor superfamily, has the potential to correct anemia by stimulating liberation of mature erythrocyte forms and also to mitigate disturbed mineral and bone metabolism as well. Hypoxia-inducible factor prolyl hydroxylase inhibitors also show pleiotropic effects, which are at the focus of present research and have the potential of reducing mortality. However, conventional ESAs offer an extensive body of safety evidence, against which the newer substances should be measured. Carbamylated EPO is devoid of Hb augmenting effects whilst exerting promising tissue protective properties. Additionally, the role of hepcidin antagonists is discussed. An innovative new hemodialysis blood tube system, reducing blood contact with air, conveys a totally different and innocuous option to improve renal anemia by reducing mechanical hemolysis.

Diagnosis and treatment for anemia of chronic kidney disease in children / 中华实用儿科临床杂志

There are many reasons for children with anemia of chronic kidney disease (CKD), such as chronic renal insufficiency due to lack of raw materies erythropoietin(iron,folic acid, vitamin B12 deficiency), shortening of the life of red blood cells and blood loss, bone marrow suppression by urine toxins such as erythropoietin.But the main reason is decreased production of renal erythropoietin accompanying chronic renal insufficiency.Anemia affects tissue's oxygen supply, utilization, and cardiac output, and patients often show a series of pathophysiology of immune dysfunction,such as fatigue, difficulty in breathing, enlargement of the hearts, ventricular hypertrophy, heart failure, cerebral insufficiency ,cognitive decline ,affecting the prognosis and quality of life of patients.Renal anemia requires aggressive treatment,which is closely related to the survival and quality of life in patients with chronic renal failure.This paper elaborates on the diagnosis of anemia in children with CKD, the evaluation strategies of anemia,iron therapy and erythropoiesis stimulating agents treatment.