Linked Life Data

7702070

Source:http://linkedlifedata.com/resource/pubmed/id/7702070

Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
4 Suppl 1
pubmed:dateCreated
1995-5-4
pubmed:abstractText
Recombinant human erythropoietin (epoetin) therapy had a significant impact on the practice of nephrology before its widespread use in the dialysis arena. Since then, a number of long-term studies have provided physicians with parameters for optimizing therapeutic response and patient outcomes with epoetin therapy. Fears of accelerated hypertension syndromes or increased fistula clotting are recognized as largely unfounded. There is a marked improvement in well-being, as measured by both subjective and objective parameters, as the level of anemia is reduced. Fortunately, epoetin was recognized early as essential therapy in patients on dialysis and thus was reimbursed by the Health Care Financing Administration (HCFA) and other payers, albeit through various methods of payment. Why is it, then, that hematocrit levels are still averaging approximately 30%? Perhaps the basic concern that all practitioners share is the potential for increased morbidity at "higher" hematocrit levels. Increased access clotting was not reported in the recently completed Epogen (Epoetin alfa; Amgen Inc, Thousand Oaks, CA) phase IV postmarketing study. Needle size, however, needs to be considered, because higher blood flow rates accompanied by higher hematocrit levels may lead to increased hemolysis. The venous needle size is especially important in patients who experience large weight gains. It is important to keep these issues in mind as one decides on an appropriate hematocrit level for a given patient. Hull and Eschbach reviewed postdialysis data from patients with naturally occurring high hematocrit levels and found no major changes in hematocrit level, thus alleviating the concern of significant postdialysis inspissation as a common cause for fistula clotting.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Apr
pubmed:issn
0272-6386
pubmed:author
pubmed:issnType
Print
pubmed:volume
25
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
S12-7
pubmed:dateRevised
2004-11-17
pubmed:meshHeading
pubmed:year
1995
pubmed:articleTitle
Adapting the dialysis unit to increased hematocrit levels.
pubmed:affiliation
Department of Hypertension/Nephrology, Cleveland Clinic Foundation, OH 44195, USA.
pubmed:publicationType
Journal Article