Kerr Peter G
Department of Nephrology, Monash Medical Centre, Melbourne, Victoria, Australia.
Nephrology (Carlton). 2006 Dec;11(6):542-8. doi: 10.1111/j.1440-1797.2006.00701.x.
The morbidity, mortality and economic burden of chronic kidney disease (CKD) and associated anaemia are substantial. With the increasing numbers of patients who are likely to be affected in the future, approaches are required to improve anaemia management without increasing the burden on health-care professionals. A multidisciplinary approach to treatment, where early initiation of erythropoiesis-stimulating agents (ESA) is encouraged, may improve patient outcomes. Recent studies also suggest that the early use of iron therapy in patients with CKD not on dialysis may be associated with beneficial effects on haemoglobin levels. Another strategy to reduce the burden on health-care providers is to simplify anaemia management by extending the administration interval of ESA. Indeed, recent studies have explored the efficacy of extending the administration interval of ESA in clinical practice in CKD patients on dialysis and not on dialysis. The ability to maintain haemoglobin levels within guideline ranges at extended administration intervals may improve patient care and reduce the workload of health-care providers.
慢性肾脏病（CKD）及相关贫血的发病率、死亡率和经济负担都相当大。鉴于未来可能受影响的患者数量不断增加，需要采取方法来改善贫血管理，同时又不增加医护人员的负担。鼓励早期启用促红细胞生成素（ESA）的多学科治疗方法可能会改善患者预后。近期研究还表明，未接受透析的CKD患者早期使用铁剂治疗可能对血红蛋白水平有有益影响。减轻医护人员负担的另一个策略是通过延长ESA给药间隔来简化贫血管理。事实上，近期研究已探讨了在接受透析和未接受透析的CKD患者临床实践中延长ESA给药间隔的疗效。在延长给药间隔时将血红蛋白水平维持在指南范围内的能力可能会改善患者护理并减轻医护人员的工作量。
