Cyclophosphamide In Kidney Disease
ironjustice
bloodletting.
Increased red blood cell production is found in diabetes and kidney
disease.
In lupus they use a drug which lowers red blood cell count and
curiously
with lupus TOO commonly have .. kidney disease.
Coincidence .. of .. course.
"Cyclophosphamide depresses erythropoietin "
EULAR 2009: Intravenous Cyclophosphamide Superior to Oral
Cyclophosphamide as Induction Therapy in Lupus Nephritis
Alice Goodman
"Real-life" studies in patients with lupus nephritis show that
intravenous (IV) cyclophosphamide is superior to oral
cyclophosphamide as induction therapy and that patients with
end-stage renal disease (ESRD) can be safely managed with
kidney transplantation.
"Almost Half of Those Over 60 Die While Waiting for Kidney Transplant"
These are the conclusions of 2 separate single-center studies
presented here at EULAR 2009: The Annual European Congress
of Rheumatology.
In a retrospective single-center study of patients with diffuse
proliferative lupus nephritis, IV cyclophosphamide was superior
to oral cyclophosphamide as induction therapy.
"Our results show that IV in cyclophosphamide as induction therapy
is highly beneficial in Caucasian patients, compared with oral
cyclophosphamide," said lead presenter M. Ramos-Casals, MD,
from the Hospital Clinic in Barcelona, Spain.
"These results are similar to those in Caucasian European patients,
but in contrast with studies in North American and Asian patients."
Dose, Length of Cyclophosphamide Should Be Customized
Dr. Ramos-Casals said that the dose and length of cyclophosphamide
needs to be individualized according to the patient's age, sex, and
ethnicity.
She explained that the response to oral cyclophosphamide in this study
is
different from what has been reported in the literature, which she
attributed
to the introduction of newer medications, such as mycophenolate, that
have
come into use.
The investigators reviewed the outcomes of 206 patients diagnosed with
lupus
nephropathy between 1979 and 2007.
Mean age at diagnosis was 31 years, and renal biopsy showed class IV
nephritis, the focus of the study, in 81 patients (39%).
All patients were treated with prednisone and immunosuppressive
drugs.
Induction therapy with cyclophosphamide was given to 62 (83%) of the
81
patients as part of the therapeutic regimen.
Thirty-four patients received IV cyclophosphamide, 13 received oral
cyclophosphamide, and 15 did not complete cyclophosphamide induction
therapy.
Remission of lupus nephritis, defined as normalization of serum
creatinine,
was achieved in 82% of patients who received IV cyclophosphamide, in
50% who received oral cyclophosphamide, and in 36% who did not
complete
cyclophosphamide induction therapy.
Patients treated with IV cyclophosphamide also had improved renal
response,
less renal failure, fewer infections, and fewer cytopenias than those
treated
with oral cyclophosphamide.
Frequency of death was 0% in those who received IV cyclophosphamide,
13% in those who received oral cyclophosphamide, and 23% in those who
did
not complete cyclophosphamide induction therapy.
Kidney Transplantation an Alternative to Renal Replacement Therapy
In a separate study at the same center, 22 years of experience (1986
to 2008)
showed that kidney transplantation was a good alternative to renal
replacement
therapy in systemic lupus erythematosus (SLE) patients with kidney
failure due
to lupus nephritis.
"In our series, we had similar rates of graft failure and survival as
reported with
end-stage renal disease in other populations," said Gerald Espinosa,
MD, from
the Hospital Clinic in Barcelona.
Two factors were associated with graft rejection: antiphospholipid
antibodies
(APS) and hepatitis C virus (HCV) infection.
"Both of these are treatable conditions.
Anticoagulation is recommended for these patients, but some reports
have related
anticoagulation to hemorrhagic complications, so the management of
these patients
is difficult," he stated.
Forty kidney transplantations were performed in 29 patients between
January 1986
and December 2008. Twenty patients had a single transplant, 22 (76%)
had class
IV lupus nephritis, and 83% were female.
Eleven cases of graft failure were reported (6 of 9 who were HCV-
positive and 5 of
20 who were HCV-negative).
APS antibodies were present in 76% of graft rejections and in 17% of
functional
grafts.
Nine patients had retransplantations; 13 of the grafts deteriorated
and those patients
went on to dialysis (7 were HCV-positive).
Two of these patients died.
"Cyclophosphamide Works"
"The clear message is that intravenous cyclophosphamide works and
still should
be considered effective.
The other message is that if therapy for renal lupus doesn't prevent
renal failure,
patients can survive with a kidney transplant.
Lupus [patients are] not different from nonlupus patients with ESRD —
they can be
transplanted," said Martin Aringer, MD, from the University of Dresden
in Germany,
who chaired the SLE session where these 2 presentations were given.
Dr. Ramos-Casals, Dr. Espinosa, and Dr. Aringer have disclosed no
relevant financial
relationships.
EULAR 2009: The Annual European Congress of Rheumatology:
Abstracts OP-0011 and OP-0013. Presented June 11, 2009.
---------------------------
"Inhibitory effect of dexamethasone on in vivo erythropoiesis"
"Erythropoietic depression was elicited by cyclophosphamide
administration"
It's curious how these VERY popular drugs .. reduce blood cell count.
Reduce the number of red blood cells.
Somewhat like .. bloodletting.
Enhanced hypoxia-stimulated erythropoietin production in mice with
depression of erythropoiesis induced by hyperoxia.
High Alt Med Biol. 2003 Spring;4(1):73-9.
Bozzini CE, Barceló AC, Conti MI, Martínez MP, Alippi RM.
Department of Physiology, Faculty of Odontology, University of Buenos
Aires, Argentina. ceb...@fisio.odon.uba.ar
Current evidence suggests that a modulatory action on O(2)-dependent
EPO secretion is exerted by the erythroid/precursor cell population
in
the erythropoietic organs through a negative feedback system.
The hypothesis is based on studies of stimulated-EPO secretion
performed in mice in whom the erythropoietic rates were either
enhanced or depressed in the presence of normal plasma EPO half-
lives.
Since erythropoietic depression was elicited by cyclophosphamide
administration, which could have altered EPO production directly, the
aim of the present investigation was to estimate hypoxia-stimulated
EPO secretion in a mouse model of functional depressed erythropoiesis
induced by exposure to normobaric hyperoxia.
Females CF#1 mice aged 70 d were divided into control (C) and
experimental (E) groups.
The former was maintained in plastic cages in a normal environment,
while the latter was placed in an environment of 60% O(2)/40% N(2) in
an 85-dm(3) atmospheric chamber with air flow of 1 L/min.
Erythropoiesis was evaluated by either 24-h RBC-(59)Fe uptake or iron
kinetics performed 3 h after IV injection of a tracer dose of (59)Fe.
Both indexes of the red cell production rate were significantly
depressed in E mice. Plasma disappearance of exogenous EPO in C mice,
as well as in E mice exposed to hyperoxia for 4 d, was estimated by
injecting (125)I-rHuEPO intravenously.
Linear regression analysis indicated that neither the differences
between the slopes of both curves nor the Y-intercepts were
significant.
Hypobaric hypoxemia was used as stimulus for EPO production.
Plasma immuno-EPO titer after a 4-h exposure to hypobaric air was 73%
higher in mice with hyperoxia-induced hypoerythropoiesis than in
control mice with normal erythropoiesis.
Data support the concept that the rate of erythropoiesis, perhaps
through the number of the erythroid progenitor/precursor cell
population, modulates O(2)-dependent EPO secretion.
PMID: 12713714
-------------------
Almost Half of Those Over 60 Die While Waiting for
Kidney Transplant
By Serena Gordon
HealthDay Reporter
THURSDAY, June 18 (HealthDay News) -- Nearly one
of every two people over the age of 60 who are hoping
for a kidney transplant will die while on the waiting list,
new research shows.
The study also found that other factors, such as having
diabetes, being black, having certain blood types, being
older than 70, or waiting for a transplant in certain areas
of the country increased the odds that someone would
die while waiting for a donated kidney.
"The prognosis, particularly for older patients waiting for
a kidney transplant, has deteriorated rapidly over the past
decade," said study author Jesse Schold, an assistant
professor of medicine at the University of Florida in
Gainesville.
"Wait-list times have increased, but the rate of transplant
hasn't increased markedly," he explained, adding that this
leaves "older candidates at a significantly greater risk,
because they have a higher risk of mortality in general."
Results of the study were published in the June 18 online
edition of the Clinical Journal of the American Society of
Nephrology.
Schold said the findings emphasize the need for people to
get on transplant waiting lists immediately.
"If you know this is something you're interested in, get on
a waiting list before you even start dialysis, if possible," he
advised.
Dr. Robert Provenzano, chief of nephrology for St. John
Hospital and Medical Center in Detroit, agreed that people
should get on a waiting list as soon as possible and consider
getting on the waiting list at more than one medical center
to improve the odds of getting a donated kidney.
The current study looked at data from 1995 through 2007 and
included 54,669 candidates who were older than 60 and on a
waiting list for a kidney transplant.
Of those listed in 2006 and 2007, the researchers projected
that 46% would die while on the waiting list.
In 1995, that number was just 22%, according to the study.
Those over 70 fared even worse, with 52% expected to die before
receiving a kidney transplant.
The researchers found a wide disparity -- from 6% to 81% -- in
the risk of dying while on the waiting list from region to region.
The areas with the lowest death rates while on the waiting list
include Alaska, Hawaii, Idaho, Montana, Oregon and Washington.
Areas with the highest deaths for people over 60 while on the
kidney transplant list include California, Arizona, Nevada, New
Mexico and Utah.
The study also found a racial disparity, with 62% of blacks expected
to die while waiting for a kidney transplant.
Schold said that it can be harder for blacks to find a good matching
donor under the current allocation system, and that donations tend to
be lower within minority groups.
But, he added, these factors are improving.
Other factors that increased the rate of death while on the
transplant
list included having blood type B or O, having diabetes, or already
being
on dialysis at the time you're put on the transplant list.
Both Schold and Provenzano said the findings highlight the need to
reach
out more to living donors, because the need for donated kidneys far
exceeds
the number of donations obtained from the deceased.
Even if your loved one isn't an exact match, it's possible your doctor
may
be able to find a paired donation in which your willing donor gives
his or her
kidney to someone else, and that person's loved one gives his or her
kidney
to you.
Recently, some medical centers have created living donor chains that
have
an even greater potential to increase the number of transplants.
"Be proactive in navigating the steps needed to get a transplant, and
consider
the center that's in your best interest.
You have choices," Schold said.
Provenzano also said it's critical to "take care of yourself.
Sometimes people on dialysis continue to be their own worst
enemy by pushing off dialysis appointments.
But, the more dialysis, the better.
If you can get on night-time dialysis or home dialysis, you'll
probably do significantly better."
SOURCES: Jesse D. Schold, Ph.D., assistant professor of
medicine, University of Florida, Gainesville; Robert Provenzano,
M.D., chief, nephrology, St. John Hospital and Medical Center,
Detroit; June 18, 2009,
Clinical Journal of the American Society of Nephrology, online
Copyright © 2009 ScoutNews, LLC. All rights reserved.
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Tom
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ironjustice
Chemical lowering of red blood cells / cyclophosphamide /
bloodletting. <<
Using .. logic .. then ..
If age-related macular degeneration is reversed by the reduction of
viscosity /
thick blood .. and since erythrocytosis IS thick blood then one can ..
assume ..
those with lupus would have a MUCH higher rate of ARMD than the
general
pop - ulatiion ..
http://www.newswithviews.com/Howenstine/james60.htm
"Arteriosclerosis, cancer, cataracts, gingivitis, emphysema, asthma,
systemic
candidiasis, multiple sclerosis, all infections (viral, bacterial,
parasitic, fungal),
migraine headaches, allergic diseases, cerebral palsy, Alzheimer’s
Disease,
Parkinson’s Disease, macular degeneration and systemic lupus
erythematosus."
Ken
ironjustice
The atheist .. shteating .. btch .. posts to my threads one more ..
time ..
Heh .. heh ..
Display that predatory nature .. common to .. you .. shteaters .. for
me ..
Ok .. atheist .. ?
Gooood ..
Place .. your predatory .. shteating atheist .. sht .. just below ..
Ok .. shteater ..?
Do a little .. dance .. while you .. doooo ..
To the tune ... of .. I'm a little teapot ..
"I'm a little .. athe-ist .. full .. of .. sht ..
This is my .. na-ture .. this is my .. snout"
Oink .. oink ..
Heh .. heh ..
Giiiiiiit .. you twisted fkg .. atheist .. shteater ..
Giiiiit .. atheist ..
------------------
Chemical lowering of red blood cells / cyclophosphamide /
bloodletting.
Increased red blood cell production is found in diabetes and kidney
"Cyclophosphamide depresses erythropoietin "
"Cyclophosphamide Works"
---------------------------
PMID: 12713714
-------------------
Those over 70 fared even worse, with 52% expected to die before ...
--------------------------
Ken
ironjustice
The predatory .. atheist .. shteating .. btch .. insists on posting to
my threads ..
Heh .. heh ..
You continue to display that predatory nature .. common to .. you ..
atheists ..
dog fkrs .. homosexuals .. and pedophiles ..
Place .. your predatory .. shteating atheist .. sht .. just below ..
Ok .. shteater ..?
Make sure to do that little .. dance .. while you .. doooo ..
That shteater .. dog fkg .. atheist .. dance ..
To the tune ... of .. I'm a little teapot ..
SHOUT .. it .. out ..
River .. dance .. it .. shteater ..
"I'm a little .. athe-ist .. full .. of .. sht .."
Heh .. heh ..
Giiiiiiit .. you twisted dog fkg .. atheist .. shteater ..
ironjustice
ironjustice
Atheist .. btch ..
SHOUT .. it .. out .. btch ..
River .. dance .. it .. shteater ..
"I'm a little .. athe-ist .. full .. of .. sht .."
------------------
Ken
ironjustice
<<
ALL you predatory atheist fks were told to stay off my threads ..
Homosexual predatory atheists .. were .. specifically .. TOLD ..
Write it .. down .. shteater ..
Giiiiit .. you .. atheist .. btch ..
Giiiiiit .. atheist ..
Git ..
Do that little .. atheist dance .. while you .. doooo .. shteater ..
SHOUT it .. out .. btch ..
To the tune ... of .. I'm a little teapot ..
"I'm a little .. athe-ist .. FULL .. of .. sht .."
-----------
Chemical lowering of red blood cells / cyclophosphamide /
bloodletting.
"Cyclophosphamide depresses erythropoietin "
"Cyclophosphamide Works"
---------------------------
PMID: 12713714
-------------------
receiving a kidney transplant.
Ken
ironjustice
<<
Predatory atheists were told to stay off my threads ..
Homosexual predatory atheists .. were .. specifically .. TOLD ..
You are to write it .. down .. atheist ..
Giiiiit .. you .. atheist .. btch ..
Giiiiiit .. over to alt.atheist .. or alt.atheism .. or
alt.predatory.coprophagits ..
or alt.coprophagit.predatory.atheist or
alt.predatory.coprophagit.atheism ..
Something that expresses the .. meaning .. of that .. predatory ..
nature ..
common to you atheists and homosexuals and pedophiles ..
Git .. atheist ..
Make SURE you do that little .. atheist dance .. shteater ..
SHOUT it .. out .. btch ..
"I'm a little .. lmp-dck .. FULL .. of .. sht .."
Heh .. heh ..
Atheist .. btch ..
▂ ▃ ▄ ▅ ▆ ▇ █ Derick P. Burns █ ▇ ▆ ▅ ▄ ▃ ▂
"ironjustice" <teamt...@hotmail.com> wrote in message
news:2c94bc4d-1274-455d...@o5g2000prh.googlegroups.com...
Predatory atheists were told to stay off my threads ..
You don't own any threads. Stupid
Ken
ironjustice
<<
You continue to evidence that predatory nature found in you atheist
homosexuals and pedophiles ..
Don't you .. atheist ..
ALL you predatory atheist fks were told to stay off my threads ..
You atheist shteaters .. were .. specifically .. TOLD ..
Write it .. down .. atheist ..
Giiiiiit .. shteater ..
Giiiiit ..atheist ..
Giiiiiiit ..