de Francisco Angel L M, Fernandez Fresnedo Gema, Rodrigo Emilio, Piñera Celestino, Heras Milagros, Palomar Rosa, Ruiz Juan C, Arias Manuel
Nephrology Service, Hospital Universitario Marqués de Valdecilla, Santander, Spain.
Int Urol Nephrol. 2002;33(1):187-93. doi: 10.1023/a:1014478704766.
More than a decade has passed since the first patient with end-stage renal failure was treated with erythropoietin (EPO) and more than 85% of patients now receive this therapy. In the year 2002 more than 60% of dialysis patients will be elderly, and the treatment of anemia will be more complex due to the aditional causes: folate, iron and vitamin deficiency in this population. Correction of anemia with EPO brings about partial regression of left ventricular hypertrophy and some data suggest that such treatment reduces cardiovascular mortality in patients without advance cardiac disease. Normalization of hematocrit with EPO increases oxygen supply to the brain tissue with improvement in brain function. The improvement in the ability to recognize, discriminate and hold stimuli in memory for difficult tasks is particularly important for elderly people. No differences have been noted in the incidence of clotting of vascular access in patients treated with EPO compared with hemodialysis patients not so treated. Also no one has demostrated that treatment with EPO accelerates renal decline in patients with progressive renal insufficiency. In elderly people with anemia secondary to advanced renal failure, EPO therapy improves physical, cognitive and sexual function, and health related quality of life.
自首位终末期肾衰竭患者接受促红细胞生成素（EPO）治疗以来，十多年已经过去，如今超过85%的患者接受这种治疗。到2002年，超过60%的透析患者将是老年人，由于该人群中存在额外的病因：叶酸、铁和维生素缺乏，贫血的治疗将更加复杂。用EPO纠正贫血可使左心室肥厚部分消退，一些数据表明，这种治疗可降低无严重心脏病患者的心血管死亡率。用EPO使血细胞比容正常化可增加脑组织的氧气供应，改善脑功能。对于老年人来说，提高识别、辨别和记住困难任务刺激的能力尤为重要。与未接受EPO治疗的血液透析患者相比，接受EPO治疗的患者血管通路凝血发生率没有差异。也没有人证明用EPO治疗会加速进行性肾功能不全患者的肾功能衰退。在因晚期肾衰竭继发贫血的老年人中，EPO治疗可改善身体、认知和性功能以及与健康相关的生活质量。
