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Anemia at older age: etiologies, clinical implications, and management

Anemia is quite frequently diagnosed in older individuals and is a key indicator of various reactive and clonal conditions. Many underlying diseases, like myelodysplastic syndrome (MDS), develop preferentially in elderly individuals. The prevalence of anemia at older age is increasing, and this is mainly attributable to more frequently applied diagnostics and demographic changes in our societies. The etiology of anemia at older age is complex and ranges from bone marrow failure syndromes to chronic kidney disease, and from nutritional deficiencies to inflammatory processes including inflammaging in immunosenescence. In a smaller number of cases, no clear-cut etiology is identified. These patients are referred to as unexplained anemia or idiopathic cytopenia of unknown significance. In others, somatic mutations in leukocytes are found, but diagnostic criteria for MDS or other hematologic diseases are not fulfilled, a condition termed clonal cytopenia of undetermined significance. Management of anemias at older age depends on (1) the severity of the anemia, (2) underlying condition(s), and (3) patient-related factors, including comorbidities. Even a mild anemia may substantially affect physical and cognitive capacities and quality of life. An underestimated aspect is that because of age-related changes, organ function such as erythropoietin production in the kidney may become suboptimal. Management and treatment of anemia in older patients often require a multidisciplinary appr...
Source: Blood - Category: Hematology Authors: Tags: Free Research Articles, Red Cells, Iron, and Erythropoiesis, Review Articles, Review Series, Clinical Trials and Observations Source Type: research

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Authors: Stahlschmidt A, Novelo B, Alexi Freitas L, Cavalcante Passos S, Dussián-Sarria JA, Félix EA, Wajnberg Gamermann P, Caumo W, Cadore Stefani LP Abstract INTRODUCTION: Morbidity and mortality associated with urgent or emergency surgeries are high compared to elective procedures. Perioperative risk scores identify the non-elective character as an independent factor of complications and death. The present study aims to characterize the population undergoing non-elective surgeries at the Hospital de Clínicas de Porto Alegre and identify the clinical and surgical factors associated with death...
Source: Revista Brasileira de Anestesiologia - Category: Anesthesiology Tags: Rev Bras Anestesiol Source Type: research
Primary glomerular diseases and congenital anomalies of the kidney and urinary tract are the most common causes of kidney disease in children. Although the short-term prognosis is favorable after clinical remission of nephrotic syndrome or successful surgical intervention for congenital anomalies, few studies have evaluated the implications of these and other childhood kidney diseases on the long-term risk of end-stage kidney disease (ESKD). Previous studies have suggested an increased risk of chronic kidney disease (CKD) or kidney function decline in children with a single functioning kidney, children who recover from acu...
Source: Kidney International - Category: Urology & Nephrology Authors: Tags: Nephrology Digest Source Type: research
Environmental factors drive epigenetic programming. DNA methylation is the best studied modification transmitting epigenetic information. A study by Qiu et  al. examined potential epigenetic roots for the decline of renal function in Pima Indians. A genomewide survey of blood leukocytes uncovered differentially methylated DNA sites in regulatory regions of genes associated with chronic kidney disease. This longitudinal study provides the first clues o n epigenetic links between environmental factors and a high prevalence of diabetic kidney disease in Pima Indians.
Source: Kidney International - Category: Urology & Nephrology Authors: Tags: Commentary Source Type: research
Lowering LDL cholesterol reduces the risk of atherosclerotic vascular disease in a wide range of patients with chronic kidney disease, with no evidence of a threshold below which further reductions no longer reduce risk. Statins safely lower LDL cholesterol, but novel inhibitors of proprotein convertase subtilisin kexin 9 (PCSK9) provide additional reductions which may reduce atherosclerotic vascular disease yet further in this high risk population.
Source: Kidney International - Category: Urology & Nephrology Authors: Tags: Commentary Source Type: research
A 49-year-old woman with antiphospholipid syndrome and chronic kidney disease presented with a worsening of renal function (creatinine increase from 2.5 to 5.3mg/dl; glomerular filtration rate [GFR] decrease from 19 to 9 ml/min) within the last 6 months. Five years earlier, she experienced multiple arterial embolisms into iliac and renal vessels, requiring implantation of an aorto-iliac prosthesis with aorto-renal bypass graft surgery to the right. The left renal artery remained occluded. After surgery, suture insufficiency at the aorto-renal anastomosis developed with pseudoaneurysm, requiring an endoprosthesis implantation.
Source: Kidney International - Category: Urology & Nephrology Authors: Tags: Nephrology Image Source Type: research
Authors: Styszynski A, Mossakowska M, Chudek J, Puzianowska-Kuznicka M, Klich-Raczka A, Neumann-Podczaska A, Szybalska A, Wieczorowska-Tobis K Abstract Anemia is an independent risk factor for functional decline and mortality among older adults. Since mild anemia in older people is often under-diagnosed and ignored, its prevalence needs precise determination and recognition of predisposing factors. None of the previous studies based on the data obtained from the representative elderly population identified the influence of socio-economic factors on the prevalence of anemia. PolSenior was a cross-sectional populatio...
Source: Journal of Physiology and Pharmacology - Category: Drugs & Pharmacology Tags: J Physiol Pharmacol Source Type: research
Hepatosplenomegaly refers to an enlargement of the liver and spleen. Its causes include a variety of conditions that affect these two organs, including liver disease, HIV, anemia, infections, and cancer. In this article, we look at the causes, symptoms, how doctors diagnose hepatosplenomegaly, and treatment options.
Source: Health News from Medical News Today - Category: Consumer Health News Tags: Liver Disease / Hepatitis Source Type: news
ConclusionWhile 30  years ago, BEN was reported equally among immigrants and natives, currently it is diagnosed in some BEN family members in the eighth decade of life, but extremely rarely in immigrants also in old age.
Source: International Urology and Nephrology - Category: Urology & Nephrology Source Type: research
Publication date: Available online 18 May 2018 Source:American Journal of Kidney Diseases Author(s): Victoria Títoff, Heather N. Moury, Igor B. Títoff, Kevin M. Kelly There are 2 major categories of patients with seizures and chronic kidney disease (CKD): patients who develop acute symptomatic seizures in the setting of CKD and patients with epilepsy who at some point develop CKD. The incidence of uremic seizures with kidney failure is ∼10%. These seizures are often nonconvulsive and may mimic uremic encephalopathy. Recognition and management of such situations may be challenging for treating physicians ...
Source: American Journal of Kidney Diseases - Category: Urology & Nephrology Source Type: research
Conclusions In people with diabetes with reduced eGFRs, the absence of albuminuria or proteinuria is common and carries a much lower risk for ESKD, CKD progression, or rapid decline in eGFR compared with those with albuminuria or proteinuria. The rate of eGFR decline in normoalbuminuric CKD was similar to that reported for the general diabetic population.
Source: American Journal of Kidney Diseases - Category: Urology & Nephrology Source Type: research
More News: Anemia | Bone Marrow Failure Syndrome (BMFS) | Chronic Kidney Disease | Clinical Trials | Hematology | Iron | Myelodysplastic Syndrome | Nutrition | Urology & Nephrology