Deaver Kim, Bennington Lori
University of Virginia Augusta Dialysis, Fishersville, VA, USA.
Nephrol Nurs J. 2006 Jul-Aug;33(4):430-7; quiz 438.
Ongoing blood loss and iron-deficiency anemia are common problems in patients on hemodialysis; therefore, nephrology clinicians are particularly concerned with their patients who are scheduled for surgery Surgery can cause significant blood and iron losses, thereby worsening their preexisting anemia. However, patients on hemodialysis can be effectively treated preoperatively by adjusting their continued doses of intravenous (i.v.) iron and recombinant human erythropoietin (EPO) therapy, based on expected blood and iron losses. This valuable strategy can help improve surgical and anemia outcomes as well as decrease EPO requirements and the need for transfusions. This article examines the use of IV iron and EPO therapy as preventive therapy for anemia in patients on hemodialysis prior to invasive surgical procedures, illustrated with an experience from a dialysis unit and patient case studies.
持续失血和缺铁性贫血是血液透析患者的常见问题；因此，肾脏病临床医生特别关注计划接受手术的患者。手术会导致大量血液和铁流失，从而使他们原有的贫血状况恶化。然而，通过根据预期的血液和铁流失情况调整静脉注射铁剂和重组人促红细胞生成素（EPO）的持续剂量，血液透析患者术前可得到有效治疗。这一有价值的策略有助于改善手术和贫血治疗效果，同时减少对EPO的需求和输血需求。本文结合一个透析单元的经验和患者案例研究，探讨静脉注射铁剂和EPO疗法在侵入性手术前作为血液透析患者贫血预防性治疗的应用。
