Ch. 451 - Anemia of Chronic Disease

Question 1

Anemia of chronic disease is also referred to as

Answer 1

Anemia of inflammation

Question 2

Characteristics of ACD

Answer 2

Mild to moderate, normo normo, hypoproliferative, low serum iron and transferrin; modest micro hypo may be seen

Question 3

Mechanisms contributing to ACD

Answer 3

1) Decreased red cell life span 2) Impaired erythropoiesis 3) Increased uptake of iron in the RES

Question 4

Low serum iron in ACD is coupled with accumulation of serum iron in

Answer 4

RES macrophages

Question 5

Alterations in iron metab in ACD have been attributed to inflamm-associated excess synthesis of

Answer 5

Hepcidin

Question 6

A key regulatory protein that controls intestinal iron absorption and tissue distribution

Answer 6

Hepcidin

Question 7

Hepcidin is mainly synthesized by

Answer 7

Hepatocytes

Question 8

Hepcidin exerts its function by

Answer 8

Binding to and initiating degradation of the iron exporter ferroportin

Question 9

Hgb concentrations in ACD is generally at a range of

Answer 9

6-9 g/dL

Question 10

Absolute retic count in ACD

Answer 10

Normal or low

Question 11

T/F Leukocytosis is common in ACD

Answer 11

T

Question 12

IDA and ACD are similar in that there is low seurm iron but differ in terms of

Answer 12

Serum transferrin (iron-binding protein); High in IDA, low in ACD

Question 13

Best approach to ACD

Answer 13

Treatment of the underlying disorder

Question 14

Erythropoietin stimulating agents (ESAs) may be used in treatment of ACD

Answer 14

True; usually necessarily given with iron supplementation for optimal effect

Question 15

In children with CKD, Hgb levels decline as the GFT decreases below ___

Answer 15

43 ml/min/BSA

Question 16

Decreased Hgb values are linked to increased incidence of what cardiomyopathy

Answer 16

LVH

Question 17

T/F Higher hepcidin levels have also been implicated in the anemia of CKD

Answer 17

T; It is filtered by the glomerulus and excreted by the normal kidney

Question 18

Anemia of CKD, characteristics

Answer 18

Normo, normo, hypoproliferative; micro hypo may be seen in cases of concomitant IDA or vitamin deificiency

Question 19

Absolute retic count in anemia of CKD

Answer 19

Low

Question 20

White cell and platelet count in anemia of CKD

Answer 20

Normal

Question 21

T/F Oral iron therapy is recommended for all pediatric patients with CKD

Answer 21

T

Question 22

Oral iron dose recommendation for patients with anemia of CKD

Answer 22

3-6mg elemental iron/kg of target dry weight OD x 3 months

Question 23

Mainstay of therapy for anemia of CKD

Answer 23

ESAs

Question 24

It is suggested to start ESA in all children with CKD when Hgb concentrations are at ___g/dL

Answer 24

9

Question 25

Goal Hgb level for children with CKD

Answer 25

11-12 g/dL

Question 26

In the setting of ESA hyporesponsiveness, this treatment modality may be employed

Answer 26

IV iron therapy