Prevalence and factors associated with the severity of anaemia among patients on chronic haemodialysis in Lagos, Nigeria

Anaemia is a global public health problem with high mortality and morbidity. It is also a common consequence of chronic kidney disease (CKD). There is a paucity of data on the actual burden of anaemia among patients on chronic haemodialysis (CHD) in Lagos, Nigeria. Objectives: To determine the prevalence and factors associated with the severity of anaemia among Nigerian patients undergoing chronic haemodialysis. Methods: This was a retrospective analysis of adult patients with end-stage renal disease (ESRD) on maintenance haemodialysis at the Lagos State University Teaching Hospital, Ikeja, Lagos. The data extracted from the clinical case files included the bio-demographic and clinical parameters, including the treatment modalities. Results: A total of 92 patients comprising 69 (75%) males and 23 (25.0%) females with the overall mean age of 48.2±14.0 years were included. Hypertension was the commonest aetiology of CKD and the average duration of haemodialysis was 16.6 months. The commonest access route for haemodialysis was a central line while 96.7% and 81.5% received erythropoietin and intravenous iron sucrose respectively. Seventy-three (79.3%) patients have had intra-dialysis blood transfusions in the past. Mild, moderate, and severe anaemia were recorded in 17%, 67%, and 16% respectively. The use of erythropoietin, iron sucrose, and increased frequency of blood transfusions correlated with the severity of anaemia. Conclusion: Anaemia is highly prevalent among patients with CKD on chronic haemodialysis. Increased frequency of blood transfusions, inadequate utilization of erythropoietin, and iron sucrose administration are associated with anaemia severity.

Clinical observation of iron sucrose combined with recombinant human erythropoietin in the treatment of anemia of hip fracture in elderly patients / 中国骨伤

OBJECTIVE@#To explore the clinical efficacy of iron sucrose combined with recombinant human erythropoietin(EPO) for the treatment of anemia in elderly patients with hip fracture.@*METHODS@#From February 2016 to April 2018, 96 elderly anemia patients who underwent hip fracture surgery were divided into three groups according to the treatment methods. All the three groups received anti-anemia treatment 3 days before operation. Among them, 32 cases in group A were treated with iron sucrose alone, 32 cases in group B were treated with recombinant human erythropoietin alone, and 32 cases in group C were treated with iron sucrose combined with recombinant human erythropoietin. The therapeutic effects of the three groups were observed and compared.@*RESULTS@#The clinical effective rate in group C was significantly higher than that in group A and B (0.05), but the transfusion rate in group C was significantly lower than that in group A and B (0.05), but the above indexes in group C were significantly higher than those in group A and B(0.05).@*CONCLUSIONS@#Compared with single drug, the combined use of sucrose and iron and recombinant human erythropoietin in the treatment of elderly hip fracture anemia has a definite effect. It can not only effectively improve the level of hemoglobin, ensure the smooth operation, but also reduce the blood transfusion rate of patients and promote their recovery after operation.

Multi-frequency low-dose intravenous iron on oxidative stress in maintenance hemodialysis patients / 中南大学学报(医学版)

OBJECTIVE@#To investigate the effect of different intravenous iron treatment regimens on anemia and oxidative stress in maintenance hemodialysis (MHD) patients.@*METHODS@#A total of 58 MHD patients were randomly divided into a multi-frequency low-dose intravenous iron group (iron sucrose 25 mg, twice a week for 8 weeks, n=19), a less-frequency regular-dose intravenous iron group (iron sucrose 100 mg, once every two weeks for 8 weeks, n=19), and a non-iron group (n=20). Another 20 healthy people served as a control group (n=20). The changes of hemoglobin (Hb), hematocrit (HCT), serum ferritin (SF) and transferrin saturation (TSAT), as well as the oxidative stress parameters of malon-dialdehyde (MDA), superoxide dismutase (SOD) and myeloperoxidase (MPO) were detected before and after the treatment.@*RESULTS@#After 8 weeks, compared with the non-iron group, the levels of Hb, HCT, SF and TSAT in the two iron groups were significantly elevated (P0.05). After the single dialysis, the two iron groups had higher level of serum MDA, MPO and lower level of serum SOD than that of the non-iron supplementation group (P0.05).@*CONCLUSION@#Multi-frequency low-dose intravenous iron can effectively improve anemia in MHD patients, whose acute oxidative stress is lower than that of less-frequency regular-dose intravenous iron, and is a relatively safe and effective intravenous iron treatment regimen.

Avaliação da eficácia do uso intravenoso de sacarato de hidróxido de ferro III no tratamento de pacientes adultos com anemia ferropriva / Evaluation of the efficacy of intravenous iron III-hydroxide saccharate for treating adult patients with iron deficiency anemia

O objetivo desse estudo foi avaliar a eficácia do uso intravenoso de sacarato de hidróxido de ferro III no tratamento de pacientes adultos com anemia ferropriva. No período de janeiro de 2003 a dezembro de 2005, estudamos cinqüenta pacientes com anemia ferropriva que apresentaram intolerância e/ou resposta inadequada ao tratamento com ferro por via oral e/ou valor de hemoglobina inferior a 7,0 g/dL. Os principais exames laboratoriais realizados foram: hemograma completo, contagem de reticulócitos, ferro sérico, capacidade total de ligação de ferro e ferritina sérica. Os pacientes receberam uma dose semanal de 200 mg de sacarato de hidróxido de ferro III diluído em 250 mL de soro fisiológico a 0,9 por cento, administrado por via intravenosa em trinta minutos. O tratamento foi realizado até a obtenção do valor de hemoglobina igual ou maior que 12,0 g/dL para mulheres e 13,0 g/dL para homens, ou até a administração da dose total de ferro parenteral recomendada para cada paciente. A idade mediana dos cinqüenta pacientes estudados foi de 45 anos, variando entre 28 e 76 anos; quarenta (80,0 por cento) eram do sexo feminino. A causa mais comum de anemia ferropriva no sexo feminino foi sangramento uterino anormal observado em 25/40 pacientes (62,5 por cento) e, no sexo masculino, gastrectomia parcial em 7/10 (70,0 por cento). Vinte e quatro (48,0 por cento) pacientes foram incluídos nesse estudo por falta de resposta à terapia com ferro oral, 22 (44,0 por cento) por intolerância ao ferro oral e quatro (8,0 por cento) por hemoglobina < 7,0 g/dL. Os valores médios da hemoglobina e da ferritina sérica foram de 8,48 g/dL e 4,65 ng/mL (pré-tratamento) e 12,34 g/dL e 93,20 ng/mL (pós-tratamento)(p<0,001), respectivamente. O aumento médio de hemoglobina foi de 3,61 g/dL e de 4,83 g/dL para os sexos feminino e masculino, respectivamente. Correção da anemia foi obtida em 26 (65,0 por cento) das quarenta pacientes do sexo feminino e em nove (90,0 por cento)...

The objective of this study was to evaluate the efficacy of intravenous iron III-hydroxide saccharate to treat adult patients with iron deficiency anemia. Between January 2003 and December 2005 we studied 50 patients with iron deficiency anemia who presented intolerance or inadequate response to oral iron therapy, or hemoglobin level < 7 g/dL. The main laboratory tests performed were: complete blood cell count, reticulocyte count, serum iron, total iron-binding capacity and serum ferritin. The patients received a weekly dose of 200 mg of iron diluted in 250 mL of 0.9 percent sodium chloride solution administered intravenously during 30 minutes. It was performed until a hemoglobin level = 12.0 g/dL for women or13.0 g/dL for men was reached or completing the administration of the total dose of parenteral iron recommended for each patient. The median age of the patients studied was 45 years (age range from 18 to 76). Forty out of 25 patients (80 percent) were women. The most common cause of iron deficiency anemia was abnormal uterine bleeding observed in 62.5 percent of female patients (25 out of 40) and partial gastrectomy in 70 percent of male patients (7 out of 10). Twenty-four (48 percent) patients were included in this study due to a lack of response to oral iron therapy, 22 (44 percent) showed intolerance to oral iron and 2 (8 percent) presented with a hemoglobin level < 7.0 g/dL. The mean hemoglobin and ferritin values were 8.48 g/dL and 4.65 ng/mL (pretreatment) and 12.34 g/dL and 93.20 ng/mL (post-treatment) (p<0.001), respectively. The average increase of hemoglobin was 3.61 g/dL and 4.83 gdL for women and men, respectively. Correction of anemia was obtained in 26 out of 40 female patients (65 percent) and in 9 out of 10 male patients (90 percent). Six patients received blood transfusions before starting intravenous iron treatment. None of the 50 studied patients needed red blood cell transfusions during or after completing...