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Tsuchida A.,Sanshi Group Hikari Clinic | Paudyal P.,Gunma University | Ishii Y.,Sanshi Group Hikari Clinic | Hiromura K.,Sanshi Group Hikari Clinic | And 2 more authors.
Experimental and Therapeutic Medicine | Year: 2010

The aim of this study was to evaluate the effectiveness of oral iron to manage anemia in long-term hemodialysis (HD) patients using ultrapure dialysate. This study was prospectively conducted on 23 patients (11 males and 12 females; median age 60 years, range 35-81) who underwent HDin our hospital from March to September 2007. The patients were randomly assigned to two treatment groups. The first group of 11 patients received ferrous fumarate 305 mg per oral tablet once a day, while the second group of 12 patients received infusions of 50 mg iron in a 0.9% sodium chloride solution. At the end of the 6-month treatment, patients receiving oral iron and intravenous iron had a significant increase in transferrin saturation from baseline (20.1±8.9 to 29.7±7.2; p=0.011 and 17.4±6.1 to 33.7±8.6; p=0.0001, respectively) and ferritin (32.6±15.4 to 115.4±28.2; p=0.0001 and 57.8±26.7 to 183.5±47.5; p=0.0002, respectively). In both groups, hemoglobin, hematocrit and dry weight were increased, but did not reach statistical significance. Moreover, both groups showed a significant reduction in the mean weekly erythropoietin dose from baseline (5,590.9±1,513.6 to 3,727.3±1,618.1; p=0.011 and 6,775.8±2,292.2 to 4,375.0±2,473.7; p=0.027, respectively). Oral iron is indeed as effective as intravenous iron in managing anemia in HD patients using ultrapure dialysate.

Akiyasu T.,Sanshi Group Hikari Clinic | Paudyal B.,Sanshi Group Hikari Clinic | Paudyal B.,Gunma University | Paudyal P.,Gunma University | And 7 more authors.
Therapeutic Apheresis and Dialysis | Year: 2010

We report a case of renal failure associated with the ingestion of bee pollen containing nutritional supplement. A 49-year-old male patient who had been ingesting a nutritional supplement for more than five months had breathing difficulties, anuria, exceptional weight gain (20 kg) due to systemic edema, and loss of appetite. A renal biopsy confirmed interstitial nephritis with the presence of eosinophils, which is suggestive of drug-induced acute renal failure. The nutritional supplement was ceased and hemodialysis begun. The patient's condition improved after several hemodialysis sessions, which were then stopped. Current information regarding the adverse effects of bee pollen is not very robust, therefore potential damage should be kept in mind before ingesting nutritional supplements in which it is contained. This report serves as an important reminder to the public as well as healthcare providers of the potential of renal failure related to nutritional supplements. © 2010 International Society for Apheresis.

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