Tag Archives: chronic heart failure

Table 1. Origins of anaemia Haematinic deficiency The commonest single haematinic deficiency related to anaemia in patients with CHF is iron deficiency. Around half of all patients with anaemia have evidence of iron deficiency on the basis of abnormal results for serum iron, iron binding capacity and ferritin.1,2 Folate or vitamin B12 deficiency is relatively uncommon. Iron is used by the body not only for haemoglobin production but in a variety of enzyme systems, which may be affected by iron deficiency. There are many possible reasons for iron deficiency in patients with CHF. Dietary intake may be poor in the elderly population, and blood l

The situation in the anaemia of CHF is less advanced, but in recent years there has been increasing interest in the use of both of these treatment strategies. A few small clinical trials have suggested some potential benefits of stimulating erythropoiesis with ESA therapy in heart failure anaemia, whilst the administration of IV iron has shown similar benefits even in the absence of ESA therapy. Indeed, the recently published FAIR-HF (Ferinject® Assessment in patients with Iron deficiency and chronic Heart Failure) trial1 has opened the eyes of cardiologists to the potential for this latter treatment strategy to improve the symptoms and sig

Epidemiology of anaemia in CKD The likelihood of anaemia occurring in CKD increases as renal function declines. All patients receiving haemodialysis therapy will require treatment for anaemia, and so too will almost all of those receiving peritoneal dialysis (the difference accounted for by haemodialysis exposing the patient to a greater inflammatory state, and also regular minor blood losses). Below a glomerular filtration rate (GFR) of 45 ml/min, erythropoietin secretion by the kidney declines and when patients enter stage 4 CKD (eGFR < 30 ml/min), around 30–40% will be anaemic. Aetiology of anaemia in CKD Figure 1. Factors contributi

(more…)

(more…)

Introduction End-of-life care is now a Department of Health (DoH) priority. Primary care trusts have been charged with ensuring provision of high-quality end-of-life care, utilising enhanced central funding.1 While most people would prefer not to die in hospital, many still do.2 In order to change this situation, clinicians need to establish individual patient’s preferences regarding place of death (PPD) and then work proactively towards their achievement. The DoH is promoting the use of tools to help with this, such as the Gold Standards Framework (GSF), Liverpool Care Pathway (LCP) and Preferred Place of Care Plan, all of which are applic

(more…)

No content available

No content available

No content available