促红细胞生成素联合琥珀酸亚铁片对血液透析肾性贫血患者贫血相关指标的影响

目的:探讨促红细胞生成素联合琥珀酸亚铁片对血液透析肾性贫血患者贫血相关指标的影响。方法:选取2016年8月～2019年4月收治的血液透析肾性贫血患者109例,按随机数字表法分观察组55例和对照组54例。对照组予以促红细胞生成素治疗,观察组予以促红细胞生成素联合琥珀酸亚铁片治疗。比较两组不良反应、贫血相关指标水平、红细胞携氧能力。结果:治疗后两组贫血相关指标水平均明显升高,且观察组高于对照组(P0.05);治疗后两组红细胞携氧能力均明显升高,且观察组高于对照组(P0.05);观察组不良反应发生率为3.64%(2/55)与对照组的1.85%(1/54)比较无显著性差异(P0.05)。结论:促红细胞生成素联合琥珀酸亚铁片治疗血液透析肾性贫血能有效提升红细胞携氧能力,纠正贫血症状,且不增加不良反应发生风险。     

综合护理干预在长期透析致肾性贫血患者中的应用效果观察

目的探讨综合护理干预在长期透析致肾性贫血患者中的应用效果。方法选取我院收治的120例长期接受血液透析致肾性贫血患者,按随机数字表法分为对照组(采用常规护理)、观察组(采用综合护理干预)各60例,比较两组护理前后的血红蛋白(Hb)、血清铁蛋白(SF)、转铁蛋白饱和度(TSAT)水平及不良反应,观察两组临床疗效。结果观察组治疗有效率为86.67%,高于对照组的71.67%(P0.05);观察组护理后Hb、SF、TSAT水平均高于对照组(P0.05);观察组不良反应发生率为6.67%,低于对照组的20.00%(P0.05)。结论透析患者肾性贫血应用EPO时采用综合护理干预有利于提高临床疗效,改善贫血指标,降低不良反应率。     

蔗糖铁注射液治疗透析患者肾性贫血的疗效观察

目的探讨蔗糖铁注射液治疗透析患者肾性贫血的疗效。方法选取2019年3月～2020年9月我院收治的行维持性血液透析肾性贫血患者50例,随机均分为对照组和试验组各25例。对照组患者接受常规治疗,试验组在常规治疗的基础上使用蔗糖铁注射液。比较两组患者在治疗前后各项贫血指标:铁蛋白、红细胞压积、血红蛋白、红细胞;比较治疗后两组患者的不良反应率和临床疗效。结果治疗前两组患者的各项贫血指标比较,差异不明显(P0.05),治疗后试验组的各项贫血指标均高于对照组(P0.05);治疗后试验组的不良反应率4.00%,明显低于对照组的20.00%(P0.05);治疗后试验组的总有效率96.00%,明显高于对照组的76.00%(P0.05)。结论使用蔗糖铁注射液治疗透析患者的肾性贫血,能有效改善患者贫血症状,安全性较高。     

促红细胞生成素与悬浮红细胞治疗维持性血液透析患者肾性贫血的对照研究

目的比较促红细胞生成素(Erythropoietin,EPO)与悬浮红细胞治疗终末期肾病(end-stage renal disease,ESRD)维持性血液透析(maintenance hemodialysis,MHD)患者肾性贫血的临床疗效和不良反应。方法 2010年9月至2012年12月我院收治的ESRD行MHD肾性贫血患者90例,其中45例采用EPO治疗(EPO组),45例输注悬浮红细胞治疗(输血组),比较两组治疗前后红细胞计数、血红蛋白水平变化情况以及不良反应发生率。结果两组临床疗效、不良反应发生率及治疗前后红细胞计数、血红蛋白水平差异均有统计学意义(P<0.05)。结论 EPO治疗肾性贫血患者疗效确切,不良反应较输注悬浮红细胞小,值得临床推广应用。     

生血宁片联合rhEPO对老年肾性贫血患者微炎症状态的影响

目的:探讨对老年肾性贫血患者给予生血宁片联合重组人促红细胞生成素治疗的效果及对微炎症状态的影响。方法:选取2018年3月～2019年1月收治的79例老年肾性贫血患者为研究对象,以随机数字表法分为对照组39例和观察组40例。对照组实施基础支持治疗+重组人促红细胞生成素治疗方案,观察组实施基础支持治疗+重组人促红细胞生成素+生血宁片治疗方案。比较两组治疗效果及治疗前后微炎症状态指标,并统计两组不良反应发生情况。结果:观察组治疗总有效率明显高于对照组,差异有统计学意义(P0.05);观察组治疗后血清C反应蛋白、肿瘤坏死因子α、白介素-6均低于对照组,差异有统计学意义(P0.05);两组不良反应发生率比较,差异无统计学意义(P0.05)。结论:对老年肾性贫血患者给予生血宁片联合重组人促红细胞生成素治疗的效果理想,还可显著减轻微炎症反应,安全可靠。     

加味香砂六君子汤对早中期肾性贫血患者血常规及血生化指标水平的影响

目的:探讨重组人促红素联合加味香砂六君子汤在早中期肾性贫血患者中的临床应用价值。方法 :选取102例早中期肾性贫血患者为研究对象,采用随机数字表法分成联合组(A组51例)和对照组(B组51例)两组。A组采用皮下注射重组人促红素联合口服加味香砂六君子汤方案,B组予以皮下注射重组人促红素方案。比对两组患者治疗前后相关血常规、生化指标变化差异;行为期3个月随访,分析两组患者促红素总体用量、不良反应发生情况及复发情况差异。结果:治疗后两组患者RBC、Hb、Hct等血常规指标均较治疗前显著提高,BUN、SCr、Cys C、CRP等生化指标则较治疗前显著降低(P<0.05);其中A组患者各指标改善幅度均大于B组(P<0.05);A组促红素使用总剂量为(56 716.23±1 943.12)IU,显著低于B组的(82 346.26±2 153.12)IU,差异具有统计学意义(P<0.05);在为期3个月的随访中,A组不良反应发生率为7.8%,复发率为3.9%,均显著低于B组的23.5%和15.7%(P<0.05)。结论:对早中期肾性贫血患者予以重组人促红素+加味香砂六君汤联合治疗方案,疗效确切,可有效促进其红细胞生长、肾功能改善,值得临床推广。     

左卡尼汀联合促红细胞生成素治疗维持性血透肾性贫血的临床观察

选取我院2009年7月～2012年5月行维持性血透肾性贫血患者100例,随机分为对照组与治疗组,对照组患者采用EPO皮下注射;治疗组患者在对照组治疗基础上,加用左卡尼汀静脉注射;比较两组患者临床症状改善效果及不良反应发生情况等。结果治疗组患者食欲减退、低血压、肌痉挛及心律失常等临床症状改善率均明显优于对照组(P<0.05);治疗组患者血压异常增高、高热及肝肾功能异常发生率均明显低于对照组(P<0.05);但两组患者注射部位疼痛发生率组间比较差异无统计学意义(P>0.05)。左卡尼汀联合EPO治疗维持性血透肾性贫血效果确切,可明显缓解临床症状,降低不良反应发生风险。     

左卡尼汀+促红素治疗血液透析肾性贫血的效果观察

目的观察左卡尼汀联合促红素治疗血液透析肾性贫血的临床效果。方法选取我院肾病内科2021年1月至2022年9月收治的78例住院患者,均在我院行血透治疗(Hemodialysis,HD),治疗途中均并发肾性贫血,随机分为对照组和观察组各39例。对照组给予促红素治疗,观察组给予左卡尼汀+促红素治疗,对比两组生活质量评分、心脏功能指标、贫血状态指标、不良反应发生情况与炎症指标水平。结果治疗后,观察组生活质量显著高于对照组,差异有统计学意义(P<0.05);治疗后,观察组LVEF显著高于对照组,LNMI、LADU、LVEDD评分显著低于对照组,差异有统计学意义(P<0.05);治疗后,两组贫血状态均改善,且观察组改善程度显著高于对照组,差异有统计学意义(P<0.05);观察组患者发生不良反应情况明显低于对照组,差异有统计学意义(P<0.05);治疗后,观察组患炎症指标显著低于对照组,差异有统计学意义(P<0.05)。结论左卡尼汀联合促红素治疗血液透析肾性贫血,可有效提高治疗效果,改善患者生活质量、贫血状态与心功能。     

补肾益气生血方联合促红细胞生成素治疗肾性贫血的观察和护理

目的 探讨补肾益气生血方联合促红细胞生成素治疗肾性贫血的疗效和护理措施.方法 将60例肾性贫血患者随机分成2组,治疗组30例给予促红细胞生成素皮下注射,每周2次,并口服补肾益气生血方,每日1剂,早晚分服;对照组30例只给予促红细胞生成素(怡宝)治疗.疗程均为1个月,给予相关观察和护理.结果 治疗组总有效率为90.0％,对照组为66.7％,2组比较差异有统计学意义(P＜0.05).结论 补肾益气生血方配合促红细胞生成素(怡宝)治疗肾性贫血,可明显改善患者贫血状况,积极有效的护理措施有助于患者早日康复,提高生活质量.     

促红细胞生成素对血液透析患者IL-6和红细胞免疫功能的影响

慢性肾功能衰竭(CRF)血液透析患者贫血发生率100%,且患者白细胞功能异常,细胞免疫功能低下,使CRF患者易并发感染,感染是患者死亡的主要原因之一,红细胞免疫也是机体防御感染的因素,促红细胞生成素(EPO)是治疗肾性贫血有效的方法,我们应用促红细胞生成素(宁红欣)治疗CRF患者的贫血,并以输血组作对照,观察了EPO对CRF血液透析患者IL-6和红细胞免疫功能的影响.     

Erythropoietin in continuous ambulatory peritoneal dialysis: experience with subcutaneous administration.

Experience in the use of subcutaneous erythropoietin (EPO) in 32 continuous ambulatory peritoneal dialysis (CAPD) patients is presented. All patients were treated with oral iron supplements. The total and mean +/- SD durations of EPO treatment were 466 weeks and 14.6 +/- 10.1 weeks respectively. Twenty-two patients started treatment with normal or elevated iron stores; 10 had an initial iron saturation less than 20%. The initial hematocrit was 23.8 +/- 3.7%. Thirteen patients reached a steady-state hematocrit by the end of the study period, when the mean +/- SD hematocrit for all 32 patients was 34.1 +/- 3.6%. All patients responded to EPO. The initial dose of EPO was 147.1 +/- 53.8 U/kg/week. Maintenance dose was 72 +/- 36 U/kg/week.     

Erythropoietin attenuates motor impairments induced by bilateral renal ischemia/reperfusion in rats

Neurologic sequelae remain a common and destructive problem in patients with acute kidney injury. The objective of this study was to evaluate the possible neuroprotective effect of erythropoietin (EPO) on motor impairments following bilateral renal ischemia (BRI) in two time points after reperfusion: short term (24 h) and long term (1 week). Male Wistar rats underwent BRI or sham surgery. EPO or saline administration was performed 30 min before surgery (1000 U/kg, i.p.). Explorative behaviors and motor function of the rats were evaluated by open field, rotarod, and wire grip tests. Plasma concentrations of blood urea nitrogen (BUN) and creatinine (Cr) were significantly enhanced in BRI rats 24 h after reperfusion. BRI group had only an increased level of BUN but not Cr 1 week after reperfusion. Impairment of balance function by BRI was not reversed by EPO 24 h after reperfusion, but counteracted 7 days after renal ischemia. Muscle strength had no significant differences between the groups. BRI group had a decrease in locomotor activity, and EPO could not reverse this reduction in both time points of the experiment. Although EPO could not be offered as a potential neuroprotective agent in the treatment of motor dysfunctions induced by BRI, it could be effective against balance dysfunction 1 week after renal ischemia.     

Angiotensin-converting enzyme gene polymorphism and erythropoietin requirement.

OBJECTIVES: To study the effect of angiotensin-converting enzyme (ACE) polymorphisms II, ID, and DD on erythropoietin (EPO) requirement in patients on continuous ambulatory peritoneal dialysis (CAPD) therapy. DESIGN: Retrospective observational study. SETTING: CAPD Unit, Royal London/St. Bartholomews Hospital, London, UK. PATIENTS: 46 patients on the transplant waiting list (age 20-70 years), on CAPD therapy for an average of 28 months, seen consecutively over a period of 3 months in the outpatients department. MAIN OUTCOME MEASURES: Primary end point: EPO dose requirement in different ACE genotypes. Secondary end points: C-reactive protein, ferritin, parathyroid hormone, Kt/V, duration of dialysis, folate, cause of renal failure, and whether or not patients were on ACE inhibitor therapy. RESULTS: There was a statistically significant difference (p < 0.05) in EPO requirement in the II/ID group compared to the DD group. The mean +/- standard error of EPO for the II/ID group was 144 +/- 15 U/kg/week, and for the DD group, 87 +/- 9 U/kg/week. The difference in EPO requirement could not be explained by age, C-reactive protein, ferritin, parathyroid hormone, Kt/V, duration of dialysis, folate, cause of renal failure, or whether or not patients were on ACE inhibitor therapy. CONCLUSION: In CAPD patients, ACE genotype has predictive value when determining the EPO dosage, as the III/ID genotype may be associated with a suboptimal response.     

Metabolic effects of keto acid--amino acid supplementation in patients with chronic renal insufficiency receiving a low-protein diet and recombinant human erythropoietin--a randomized controlled trial

Supplement with keto acids/amino acids (KA) and erythropoietin can independently improve the metabolic sequels of chronic renal insufficiency. Our study was designed to establish whether a supplementation with keto acids/amino acids (KA) exerts additional beneficial metabolic effects in patients with chronic renal insufficiency (CRF) treated with a low-protein diet (LPD) and recombinant human erythropoietin (EPO). In a prospective randomized controlled trial over a period of 12 months, we evaluated a total of 38 patients (20 M/18 F) aged 32-68 years with a creatinine clearance (CCr) of 20-36 ml/min. All patients were receiving EPO (40 U/kg twice a week s.c.) and a low-protein diet (0.6 g protein/kg/day and 145 kJ/kg/day). The diet of 20 patients (Group I) was supplemented with KA at a dosage of 100 mg/kg/day while 18 patients (Group II) received no supplementation. During the study period, the glomerular filtration rate slightly decreased (CCr from 28.2 +/- 3.4 to 26.4 +/- 4.1 ml/min and 29.6 +/- 4.8 to 23.4 +/- 4.4 ml/min in groups I and II, respectively and Cin); this however was more marked in Group II (Group I vs. Group II, p < 0.01). The serum levels of urea also declined (p < 0.01), more pronouncedly in Group I (p < 0.025). In Group I, there was a significant rise in the levels of leucine (p < 0.01), isoleucine (p < 0.01), valine (p < 0.02) and albumin (p < 0.01) and a decrease in protein-uria (p < 0.01). Analysis of the lipid spectrum revealed a mild yet significant decrease in total cholesterol and LDL-cholesterol (p < 0.02), more pronounced in Group I. In Group I, there was a decrease in plasma triglycerides (from 4.2 +/- 0.8 down to values a low as 2.2 +/- 0.6 mmol/L; p < 0.01) whereas HDL-cholesterol levels increased (from 0.9 +/- 0.1 to 1.2 +/- 0.1 mmol/L, p < 0.01). A further remarkable finding was a reduction in the serum concentration of free radicals (p < 0.01). We conclude that a KA supplementation in patients with CRF receiving LPD and EPO potentiates the beneficial effects on metabolism of proteins, amino acids and surprisingly, also lipids. Long-term co-administration of KA, EPO and LPD was also associated with a delay in progression of renal insufficiency and a reduction in proteinuria. Thus, concomitant administration of KA and EPO during a low-protein diet presents an effective treatment modality in the conservative management of CRF.     

Erythropoietin requirement in patients with type 2 diabetes mellitus on maintenance hemodialysis therapy

Diabetes is known to be a risk factor for the severity of anemia in non-dialyzed patients with renal failure. The aim of this study was to evaluate differences in hemoglobin (Hb) response to erythropoietin (EPO) in diabetic and nondiabetic patients on chronic hemodialysis (CHD). Sixty-four patients on CHD were included in the study: 24 type 2 diabetics (mean age, 59+/-11 years; 10 men, 14 women) and 40 nondiabetics (age, 53+/-14 years; 21 men, 19 women). All patients received a fixed dose of 50 mg ferric saccharate and EPO per week, dosed individually to achieve a target Hb level of 12 g/dl. Hb levels, ferritin, transferrin saturation (TSAT), EPO requirement (IU/kg/week), folic acid, vitamin B12 and C-reactive protein (CRP) were measured every two months. Additionally, the incidence of infectious diseases during the observation period of six months was evaluated, and a univariate correlation analysis of CRP and EPO requirements was performed in both groups. Patients with and without diabetes were divided into two groups each: those with normal CRP and those with elevated CRP. The EPO requirements of these groups were compared. Under identical iron substitution the mean Hb level increased more, but not significantly, in non-diabetic patients than in diabetic patients. After 6 months the mean Hb levels were 12.1+/-1.2 versus 11.5+/-1.2 g/dl (NS), although the actual EPO requirement was higher in diabetic than in non-diabetic subjects (244+/-122 versus 183+/-118 IU/kg/week; p<0.05). CRP after 6 months was significantly higher in diabetic than in non-diabetic patients (2.6+/-2.2 versus 1.5+/-1.3 mg/dl; p<0.05), as was the incidence of infectious disease (n/patient/month) (0.24 versus 0.08; p<0.05). The correlation coefficient between CRP and EPO requirements was statistically significant in both diabetic (r=0.547 p<0.01) and non-diabetic subjects (r=0.577; p<0.001). All other laboratory indices were similar in both groups. In the diabetic patients with normal CRP (n=6) the Hb levels achieved after six months were similar to those of non-diabetic patients (n=10) with normal CRP (11.9+/-1.1 versus 12.1+/-1.2%), and the required EPO was comparable. We conclude that the Hb response to EPO is reduced in diabetic patients on CHD. This elevated EPO requirement may be explained by a greater prevalence of infectious diseases, characterized by a significantly higher CRP level, in these patients. Other causes for the elevated EPO requirement could be excluded.     

Dosing patterns, hematologic outcomes, and costs of erythropoietic agents in anemic predialysis chronic kidney disease patients from an observational study

INTRODUCTION: Epoetin alfa (EPO) and darbepoetin alfa (DARB) are two erythropoietic agents currently available in the United States for the treatment of anemia in patients with pre-dialysis chronic kidney disease (CKD). The goal of this study was to assess and compare EPO- and DARB-treated CKD patients with respect to dosing patterns, hematologic outcomes, and associated costs. MATERIALS AND METHODS: In this multicenter, retrospective chart review, 400 charts of anemic predialysis CKD patients (200 treated with EPO and 200 treated with DARB) were sequentially selected from a large self-insured employer health insurance database. The database included both employees and their dependents. Selection criteria included patients newly initiated on EPO or DARB between July 2002 and December 2003 who had at least 24 weeks of dosing and hematologic laboratory data available. Patients with a diagnosis of malignancy or on dialysis were excluded. Dosing frequency was categorized as once weekly (QW), once every 2 weeks (Q2W), every 3 weeks (Q3W), or every 4 weeks (Q4W). Hemoglobin (Hb) levels and dates/doses of EPO and DARB administrations were recorded. Costs were calculated using 2005 wholesale acquisition costs. RESULTS: Baseline demographics were similar in the EPO and DARB groups with respect to race, sex, renal function, and Hb. Extended dosing (defined as > or =Q2W) was common in both groups. The predominant dosing frequency was Q2W (59.5% of patients) for EPO and Q3W (68.0% of patients) for DARB. Hematologic response (defined as Hb > or = 11 g/dL) was significantly greater in the EPO group at early time points (week 4: EPO 28%, DARB 12%; week 8: EPO 39%, DARB 21%; week 12: EPO 98%, DARB 89%). In both groups, 99% of patients achieved hematologic response by week 24. The mean cumulative dose during the first 12 weeks (initiation phase) was EPO 141,481 +/- 32,426 units and DARB 499 +/- 152 microg. The 24 week mean cumulative dose (initiation and maintenance phase) was EPO 243,715 +/- 39,264 units and DARB 902 +/- 265 microg, corresponding to a drug cost of EPO $2,966 and DARB $3,933 and a dose ratio of 270:1 (units EPO:microg DARB). CONCLUSION: Extended dosing frequency (> or = Q2W) was common in both groups. EPO treatment was associated with a significantly greater hematologic response at early time points (weeks 4, 8, and 12). Erythropoietic agent cost was 33% higher in the DARB group.     

Experience with a large dose (500 mg) of intravenous iron dextran and iron saccharate in peritoneal dialysis patients.

OBJECTIVE: To compare efficacy in anemia correction and side effects of large doses of intravenous (IV) iron dextran and iron saccharate preparations in peritoneal dialysis (PD) patients. SETTING: Tertiary-care teaching hospital of University of Toronto. DESIGN: Retrospective analysis of 379 PD patients who attended PD clinics in past 5 years. Of these 379 patients, 62 were selected to receive IV iron based on ferrokinetic markers of iron deficiency, noncompliance to or ineffectiveness of oral iron, or increased erythropoietin (EPO) requirement. INTERVENTION: Sixty-one patients received two IV iron injections of 500 mg each, 1 week apart, 33 patients received iron dextran, 23 received iron saccharate, and 5 received both iron dextran and iron saccharate. One patient developed anaphylaxis to a test dose of iron dextran and was excluded from further therapy. Blood samples were collected before and 3 and 6 months after iron infusions. RESULTS: At 3 months, the group's average hemoglobin rose from 98.3+/-18.3 g/L to 110.6+/-16.4 g/L (p < 0.0001). Ferritin rose from 104.9+/-115.4 microg/L to 391.5+/-294.1 microg/L (p < 0.0001), and transferrin saturation from 0.17+/-0.07 to 0.26+/-0.19 (p < 0.0001). Erythropoietin requirements fell from 7278.7 IU/week to 5900 IU/week (p < 0.01). Five of the 34 patients who received iron dextran developed minor side effects and 1 patient had anaphylaxis to the test dose. Of the 23 patients who received iron saccharate, 1 had an anaphylactic reaction and 2 had transient chest pain, which subsided without therapy. Overall, there were more side effects with iron dextran (7.4% of injections) compared to the iron saccharate group (4.3% of injections), but this difference was statistically insignificant. Although statistically insignificant, there was an increase in the number of peritonitis episodes during the 6 months after IV iron infusion, especially with iron dextran, compared to the peritonitis episodes during the 6 months before iron infusions. CONCLUSION: Our study indicates that IV iron in PD patients is effective in restoring iron stores and in decreasing EPO requirements. One anaphylactic reaction occurred in each group. Our data suggest that as much caution be exercised with iron saccharate as with iron dextran. The slight trend toward increased peritonitis rates after iron infusions needs to be investigated in a larger group of patients.     

静脉与口服铁剂治疗肾性贫血疗效的临床观察

目的:观察慢性肾功能不全患者静脉和口服补铁治疗肾性贫血的疗效、不良反应的发生情况以及对促红细胞生成素(EPO)使用效应的比较。方法:将62例肾性贫血患者随机分为静脉组和口服组,每组31例,观察期10周。所有患者均常规使用EPO治疗,剂量为100U/(kg·周),皮下注射,若患者血红蛋白(Hb)达100g/L,则将EPO剂量减少50%;若患者Hb达120g/L则将EPO剂量减少75%。口服组给予富马酸铁口服,静脉组给予蔗糖铁注射液静脉滴注。观察用药前、用药后4周、用药后8周、用药后10周的血红蛋白(Hb)、红细胞压积(Hct)、铁蛋白(SF)、不良反应以及EPO使用量。结果:治疗后两组患者的Hb、Hct、SF均较治疗前有明显升高,而静脉组升高幅度显著高于口服组(P<0.05),两组患者EPO使用量在治疗后较治疗前均有所减少,而静脉组减少明显(P<0.05),静脉组不良反应的发生率明显低于口服组,EPO的效应明显高于口服组。结论:静脉补铁能及时有效地补充肾性贫血患者所需的铁剂,使贫血状况改善,不良反应少,可安全应用,并能增强EPO效应,减少其用量。     

Correlation between fractional reabsorption of sodium and erythropoietin dose in peritoneal dialysis patients.

BACKGROUND: Erythropoietin (EPO) deficiency of chronic renal failure (CRF) may be a functional consequence of decreased glomerular filtration rate and fractional reabsorption of sodium (FR(Na)). Decreased FR(Na) reduces renal oxygen consumption and increases tissue oxygen pressure, resulting in less EPO production. We hypothesized that, in CRF patients, there is a positive relationship between EPO production and FR(Na) and that, in such patients receiving EPO, a negative correlation is expected between FR(Na) and EPO dose. METHODS: Creatinine clearance, FR(Na), serum iron, transferrin, transferrin saturation, ferritin, and intact parathyroid hormone (iPTH) levels were measured in 91 peritoneal dialysis patients. The correlation between EPO dose and FR(Na) was studied. RESULTS: Mean EPO dose was 7076 +/- 4821 units/week and mean FR(Na) was 93.40% +/- 6.14%. A negative correlation was found between EPO dose and FR(Na) (r = -0.28, p < 0.01), and a positive correlation was found between both ferritin and iPTH and EPO dose (r = 0.39, p < 0.001 and r = 0.35, p < 0.002 respectively). After adjusting for the effect of creatinine clearance, ferritin, and iPTH, there was still a significant correlation between EPO dose and FR(Na) (p < 0.05). CONCLUSION: In CRF patients there is a negative correlation between FR(Na) and EPO dose, which supports the hypothesis that EPO deficiency may be related to the decreased renal oxygen-consuming work of sodium reabsorption.     

蔗糖铁注射液治疗维持性血液透析患者肾性贫血的临床疗效

【目的】比较蔗糖铁与右旋糖酐铁注射液静脉注射治疗维持性血液透析（MHD）患者缺铁性贫血的疗效与安全性。【方法】100例MHD患者随机分为试验组（蔗糖铁组）与对照组（右旋糖酐铁组）,每组各50例。将100mg蔗糖铁和100mg右旋糖酐铁分别稀释100mL生理盐水,于每次血液透析时使用。每周治疗1次,治疗时间为10周,观察12周。两组患者的总铁量1000mg,所有病例都合并使用促红细胞生成素（EP0）治疗,剂量为每周120～150u／kg,皮下或者静脉应用。观察并比较两组患者治疗贫血的效果,铁代谢指标的变化及不良反应发生的情况。【结果】两组的血红蛋白（Hb）均较治疗前显著升高（均P〈0．01）;红细胞比容（HCT）也较治疗前显明升高（均P〈0．01）,而试验组的上升幅度大于对照组,但两组相比较差异无统计学意义（均P〈0．01）。两组血清尿素氮、肌酐、转氨酶等均无明显变化。两组患者均无严重的不良反应发生。【结论】蔗糖铁是治疗伴有缺铁性贫血血液透析患者的一种安全有效的药物。