Flashcards in Ch. 451 - Anemia of Chronic Disease Deck (26)
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1
Anemia of chronic disease is also referred to as
Anemia of inflammation
2
Characteristics of ACD
Mild to moderate, normo normo, hypoproliferative, low serum iron and transferrin; modest micro hypo may be seen
3
Mechanisms contributing to ACD
1) Decreased red cell life span 2) Impaired erythropoiesis 3) Increased uptake of iron in the RES
4
Low serum iron in ACD is coupled with accumulation of serum iron in
RES macrophages
5
Alterations in iron metab in ACD have been attributed to inflamm-associated excess synthesis of
Hepcidin
6
A key regulatory protein that controls intestinal iron absorption and tissue distribution
Hepcidin
7
Hepcidin is mainly synthesized by
Hepatocytes
8
Hepcidin exerts its function by
Binding to and initiating degradation of the iron exporter ferroportin
9
Hgb concentrations in ACD is generally at a range of
6-9 g/dL
10
Absolute retic count in ACD
Normal or low
11
T/F Leukocytosis is common in ACD
T
12
IDA and ACD are similar in that there is low seurm iron but differ in terms of
Serum transferrin (iron-binding protein); High in IDA, low in ACD
13
Best approach to ACD
Treatment of the underlying disorder
14
Erythropoietin stimulating agents (ESAs) may be used in treatment of ACD
True; usually necessarily given with iron supplementation for optimal effect
15
In children with CKD, Hgb levels decline as the GFT decreases below ___
43 ml/min/BSA
16
Decreased Hgb values are linked to increased incidence of what cardiomyopathy
LVH
17
T/F Higher hepcidin levels have also been implicated in the anemia of CKD
T; It is filtered by the glomerulus and excreted by the normal kidney
18
Anemia of CKD, characteristics
Normo, normo, hypoproliferative; micro hypo may be seen in cases of concomitant IDA or vitamin deificiency
19
Absolute retic count in anemia of CKD
Low
20
White cell and platelet count in anemia of CKD
Normal
21
T/F Oral iron therapy is recommended for all pediatric patients with CKD
T
22
Oral iron dose recommendation for patients with anemia of CKD
3-6mg elemental iron/kg of target dry weight OD x 3 months
23
Mainstay of therapy for anemia of CKD
ESAs
24
It is suggested to start ESA in all children with CKD when Hgb concentrations are at ___g/dL
9
25
Goal Hgb level for children with CKD
11-12 g/dL
26
