Breiterman-White Randee
Vanderbilt University Medical Center, USA.
Nephrol Nurs J. 2002 Oct;29(5):469-72.
New patients starting dialysis typically have hemoglobin (Hb) and hematocrit (Hct) levels well below the target range of 11 to 12 g/dL (33% to 36%) recommended by the NKF-K/DOQI. Despite the emphasis on anemia as a quality indicator, low Hb levels often persist for months after dialysis is initiated. Several factors can help promote timely correction of anemia. (a) proactively assessing anemia-related laboratory indicators, (b) calculating weight-based Epoetin alfa starting doses, (c) starting Epoetin alfa therapy on the first day of dialysis for all eligible patients, and (d) proactively assessing patients for conditions that may affect the erythropoietic response. Through proactive, protocol-mandated interventions, nurses can help ensure that anemia is corrected promptly.
开始透析的新患者，其血红蛋白（Hb）和血细胞比容（Hct）水平通常远低于美国国家肾脏基金会-肾脏疾病预后质量倡议（NKF-K/DOQI）推荐的11至12克/分升（33%至36%）的目标范围。尽管贫血作为一项质量指标受到重视，但在开始透析后的数月里，低血红蛋白水平往往持续存在。有几个因素有助于促进贫血的及时纠正。（a）主动评估与贫血相关的实验室指标；（b）根据体重计算促红细胞生成素α的起始剂量；（c）对所有符合条件的患者在透析第一天开始促红细胞生成素α治疗；（d）主动评估患者是否存在可能影响红细胞生成反应的情况。通过主动的、协议规定的干预措施，护士可以帮助确保贫血得到及时纠正。
