Yazar "Goldsmith, David" seçeneğine göre listele

Listeleniyor 1 - 2 / 2
  • Küçük Resim Yok
    Öğe
    Renal Anemia of Inflammation: The Name Is Self-Explanatory
    (KARGER, 2011) Yilmaz, Mahmut Ilker; Solak, Yalcin; Covic, Adrian; Goldsmith, David; Kanbay, Mehmet
    Background: Anemia is inevitable as chronic kidney disease (CKD) advances. With the advent of erythropoietin-stimulating agents (ESAs), considerable improvement has been achieved in the management of anemia. However, some patients show a reduced response to ESAs. Methods: Many factors affect the response to ESA treatment. CKD is now considered as an inflammatory disorder and this understanding led to the recognition of the central role of inflammation in ESA resistance. Inflammation is related to untoward outcomes, including atherosclerosis and anemia, in the CKD population. Furthermore, recognition of deleterious effects of proinflammatory markers at different levels of erythropoiesis led to a change in the name of 'anemia of chronic disease' to anemia of inflammation. Results: The discovery of hepcidin as the major controller of iron metabolism in anemia of inflammation answered many questions regarding the interaction of erythropoietin, iron and bone marrow. Hepcidin production in the liver is driven by three major factors: inflammation, iron overload and anemia/hypoxia. Hepcidin levels are increased in patients with CKD due to the interaction of many factors; a comprehensive understanding of these pathways is thus critical in the effort to alleviate anemia of inflammation and ESA resistance. Conclusion: In this review, we discussed the epidemiology, determinants and consequences of anemia of inflammation in CKD patients with special emphasis on the central role of hepcidin along with molecular pathways driving its production. Copyright (C) 2011 S. Karger AG, Basel
  • Küçük Resim Yok
    Öğe
    Sudden Cardiac Death in Patients with Chronic Kidney Disease: Prevention Is the sine qua non
    (KARGER, 2011) Kanbay, Mehmet; Solak, Yalcin; Covic, Adrian; Goldsmith, David
    Despite developments in the technology of dialysis procedures and improvements in the understanding of systemic derangements related to chronic kidney disease (CKD), cardiovascular disease is the major cause of death. Unfortunately, the leading subset of cardiovascular disease death is sudden cardiac death (SCD). To date much effort has been exerted to figure out the clues pointing to the risk of future development of SCD in patients with CKD. However, none of these factors satisfactorily detects a truly vulnerable dialysis patient. Thus, recently, it has been advocated that a combination of noninvasive risk assessment methods, carefully chosen to reflect the different aspects of the underlying pathology and changes in the myocardial substrate in CKD, could help to identify patients at high risk of SCD within the CKD. In this review, we aimed to summarize what is known about risk stratification of patients with CKD and appropriate prevention strategies with a special emphasis on recent developments and the use of complimentary tests perhaps as a risk prediction rule. Copyright (C) 2011 S. Karger AG, Basel