losartan-potassium and Pruritus

A literature review on fish oil supplementation in the population undergoing chronic hemodialysis therapy suggests that supplementation may be beneficial for various challenges to health and well-being prevalent in this population. One study indicated that pruritus symptoms improved with fish oil supplementation, but not with supplementation with two other oils. In a study designed to determine whether fish oils could prevent vascular access graft thrombosis, graft patency rates were approximately 76% in the fish oil and approximately 15% in the placebo group (P>.03). In a pilot study, subjects given fish oil required 16% less erythropoietin and experienced a 3.6% increase in serum albumin levels. Some studies suggest that fish oil supplementation in hemodialysis patients is cardioprotective, with one study finding that "fish eaters" are half as likely to die as "non-fish eaters." Potential risks of supplementation include gastrointestinal distress, prolonged bleeding, and vitamin A toxicity, although the likelihood of serious side effects is probably low. Dietitians are in a position to advise physicians and/or patients regarding appropriate dosages and ways to minimize risks when supplementation seems warranted. Future research could compare the benefits of fish consumption with those of fish oil supplementation and explore the benefits of other n-3 fatty acid sources, such as flaxseed.

Topics: Cardiovascular Diseases; Catheters, Indwelling; Dietary Supplements; Erythropoietin; Female; Fish Oils; Humans; Kidney Failure, Chronic; Male; Pruritus; Renal Dialysis; Seafood; Serum Albumin; Thrombosis

Persistent pruritus is the most common symptom in hemodialysis patients. Its causes are poorly understood and there is no effective treatment. We have studied the effect of azelastin HCL on the plasma histamine concentrations and pruritus in maintenance dialysis patients with or without erythropoietin therapy.. Twenty-eight hemodialysis patients were divided into four groups according to the presence or absence of pruritus and whether or not they received erythropoietin therapy.. Histamine concentrations in the patient groups were significantly higher than in healthy volunteers, but a significant difference could not be found among the four groups. The patients with pruritus showed no change in their histamine concentration during treatment with azelastin HCL, but their pruritus scores decreased remarkably.. The present data do not support the thesis that the increased plasma histamine concentration is causally related to pruritus in hemodialysis patients or that the antiallergic drug, azelastin HCL, alleviates the pruritus of dialysis patients by decreasing plasma histamine levels. The possible role of the increased tissue levels of histamine remains to be studied.

Topics: Adult; Aged; Erythropoietin; Female; Histamine; Histamine H1 Antagonists; Humans; Male; Middle Aged; Phthalazines; Pruritus; Renal Dialysis

The pathophysiologic aspects of pruritus in patients with chronic renal insufficiency are poorly understood, and there is no universally effective treatment. The improvement of pruritus in several patients receiving erythropoietin therapy raised the possibility that erythropoietin affects uremic pruritus directly.. We undertook a 10-week placebo-controlled, double-blind, crossover study in a group of patients receiving hemodialysis who had severe pruritus, to investigate the effects of recombinant human erythropoietin on their pruritus and plasma histamine levels. Twenty patients with uremia, of whom 10 had severe pruritus and 10 did not, received erythropoietin (36 units per kilogram of body weight three times weekly) and placebo in random order, each for five weeks. The severity of pruritus was scored weekly, and plasma histamine levels were measured at the beginning and end of each five-week period.. Eight of the 10 patients with pruritus had marked reductions in their pruritus scores during erythropoietin therapy. The mean (+/- SE) pruritus score decreased from 25 +/- 3 to 6 +/- 1 in these patients. The pruritus returned within one week after the discontinuation of therapy. The improvement was not related to the change in hemoglobin level. These eight patients were successfully treated again with low doses of erythropoietin (18 units per kilogram three times weekly), and the effect has persisted for six months. The patients with pruritus had elevated plasma histamine concentrations (20.7 +/- 2.7 nmol per liter), as compared with the patients without pruritus (4.2 +/- 0.6 nmol per liter; P less than 0.001) and normal subjects (2.1 +/- 0.2 nmol per liter; P less than 0.001). Therapy with erythropoietin induced a decrease in plasma histamine concentrations in both groups of patients with uremia, and recurrences of pruritus after the discontinuation of erythropoietin were accompanied by increases in plasma histamine concentrations.. Erythropoietin therapy lowers plasma histamine concentrations in patients with uremia and can result in marked improvement of pruritus.

Topics: Double-Blind Method; Erythropoietin; Female; Histamine; Humans; Male; Middle Aged; Pruritus; Recombinant Proteins; Renal Dialysis; Uremia

Topics: Diagnostic Screening Programs; Erythropoietin; Female; Humans; Janus Kinase 2; Male; Middle Aged; Mutation; Myeloproliferative Disorders; Polycythemia Vera; Pruritus; Retrospective Studies; Water

Iron deficiency anemia (IDA) is common in children. Limited data exist on the efficacy and safety of ferumoxytol in children.. To assess the efficacy of 10 mg/kg dose given over 15-60 minutes in correcting IDA and report any adverse drug reactions (ADRs).. We conducted a retrospective review of all patients who received ferumoxytol infusions for the management of IDA by the Pediatric Blood Management Program between October 2010 and March 2015.. A total of 110 infusions were given to 54 patients. Compared with baseline preinfusion hemoglobin (Hb; 9.2 ± 1.9 g/dL), a significant rise was seen at 1 week and 4 weeks postinfusion (11.5 ± 1.5 and 11.8 ± 1.7 g/dL, respectively, P < 0.001). Also, a significant rise in serum ferritin at 1 week and 4 weeks postinfusion was seen (51 ± 71 vs 192 ± 148 and 89 ± 135 ng/mL, P < 0.001 and <0.035, respectively). Patients who concomitantly received erythropoietin had a significantly larger Hb rise from baseline than those who did not at 4 weeks (2.7 ± 2.2 vs 1.6 ± 1.1 g/dL, P < 0.017). ADRs included pruritus (n = 1), urticaria (n = 1), and multisymptom episodes (n = 3) that included shortness of breath, chest tightness, back pain, and epigastric cramping that responded to therapy with IV diphenhydramine and methylprednisolone.. Ferumoxytol was effective in treating IDA in our small study. Slow infusion rate and close monitoring allowed early detection of the infrequent ADRs.

Topics: Adolescent; Anemia, Iron-Deficiency; Child; Child, Preschool; Erythropoietin; Female; Ferrosoferric Oxide; Hemoglobins; Humans; Infant; Infant, Newborn; Infusions, Intravenous; Male; Methylprednisolone; Pruritus; Retrospective Studies; Young Adult

Topics: Aged; Aged, 80 and over; Anemia; Antihypertensive Agents; Comorbidity; Erythropoietin; Female; Home Care Services, Hospital-Based; Hospitalization; Hospitals, University; House Calls; Humans; Hypertension; Kaplan-Meier Estimate; Male; Middle Aged; Nephrology; Palliative Care; Prospective Studies; Pruritus; Severity of Illness Index; Spain; Survival Rate; Terminal Care; Uremia; Water-Electrolyte Imbalance

Topics: Erythropoietin; Histamine; Humans; Pruritus; Renal Dialysis; Uremia

Topics: Erythropoietin; Histamine; Humans; Kidney Failure, Chronic; Pruritus

Topics: Erythropoietin; Hemoglobins; Humans; Pruritus; Uremia

Topics: Erythropoietin; Humans; Ketotifen; Pruritus; Uremia

Topics: Erythropoietin; Humans; Middle Aged; Peritoneal Dialysis, Continuous Ambulatory; Pruritus; Renal Dialysis; Reproducibility of Results; Uremia

Topics: Erythropoietin; Histamine; Humans; Pruritus; Uremia

Topics: Adult; Aged; Alkaline Phosphatase; Blood Platelets; Blood Volume; Bone Marrow; Chlorambucil; Erythrocyte Count; Erythropoietin; Female; Hemoglobins, Abnormal; Hookworm Infections; Humans; Hydrogen-Ion Concentration; Leukocyte Count; Male; Middle Aged; Oxygen; Phosphorus Radioisotopes; Polycythemia; Polycythemia Vera; Pruritus; Riboflavin Deficiency; Uric Acid; Vitamin B 12