title: Anemia in nephrotic syndrome: approach to evaluation and treatment.
abstract: Nephrotic syndrome is one of the most common glomerular diseases that affect in children. Complications may occur in nephrotic syndrome as a result of the disease itself as well as its treatment. Most of these complications result from excessive urinary protein losses, and control of proteinuria is the most effective treatment strategy. Anemia is one of the many complications seen in patients with persistent nephrotic syndrome and may occur as a result of excessive urinary losses of iron, transferrin, erythropoietin, transcobalamin and/or metals. This leads to a deficiency of substrates necessary for effective erythropoiesis, requiring supplementation in order to correct the anemia. Supplementation of iron and erythropoietin alone often does not lead to correction of the anemia, suggesting other possible mechanisms which need further investigation. A clear understanding of the pathophysiologic mechanisms of anemia in nephrotic syndrome is necessary to guide appropriate therapy, but only limited evidence is currently available on the precise etiologic mechanisms of anemia in nephrotic syndrome. In this review we focus on the current state of knowledge on the pathogenesis of anemia in nephrotic syndrome.
authors.affiliation: Division of Pediatric Nephrology, Department of Pediatrics, Louisiana State University Health Sciences Center, 200 Henry Clay Avenue, Rm 4241, Now Orleans, LA, 70118, USA.
authors.forename: Franca
authors.initials: F
authors.lastname: Iorember
authors.affiliation: Division of Pediatric Nephrology, Department of Pediatrics, Louisiana State University Health Sciences Center, 200 Henry Clay Avenue, Rm 4241, Now Orleans, LA, 70118, USA. DAvile@lsuhsc.edu.
authors.forename: Diego
authors.initials: D
authors.lastname: Aviles
mesh_terms: D000740:Anemia / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy* / Q000652:urine; D002648:Child; D000068817:Epoetin Alfa / Q000627:therapeutic use; D004920:Erythropoiesis; D004921:Erythropoietin / Q000378:metabolism / Q000652:urine; D005942:Gluconates / Q000627:therapeutic use; D006397:Hematinics / Q000627:therapeutic use*; D006801:Humans; D007501:Iron / Q000378:metabolism / Q000627:therapeutic use / Q000652:urine; D007668:Kidney / Q000503:physiopathology*; D009404:Nephrotic Syndrome / Q000150:complications* / Q000652:urine; D011507:Proteinuria / Q000652:urine; D065667:Renal Elimination; D014168:Transferrin; D016896:Treatment Outcome; D014815:Vitamins / Q000627:therapeutic use
chemical_list: C554270:EPO protein, human; D005942:Gluconates; D006397:Hematinics; D014168:Transferrin; D014815:Vitamins; D004921:Erythropoietin; D000068817:Epoetin Alfa; D007501:Iron
keywords: Anemia in nephrotic syndrome; Erythropoiesis; Erythropoietin deficiency; Iron hemostasis; Proteinuria