英国肾脏注册机构第11次年度报告（2008年12月）：第9章 2007年英国接受透析治疗患者的血红蛋白、铁蛋白和促红细胞生成素：全国及各中心具体分析
UK Renal Registry 11th Annual Report (December 2008): Chapter 9 Haemoglobin, ferritin and erythropoietin amongst patients receiving dialysis in the UK in 2007: national and centre-specific analyses.
作者信息
Richardson Donald, Ford Daniel, Gilg Julie, Williams Andrew J
机构信息
York District General Hospital, York, UK.
出版信息
Nephron Clin Pract. 2009;111 Suppl 1:c149-83. doi: 10.1159/000209998. Epub 2009 Mar 26.
BACKGROUND
The UK Renal Association (RA) and National Institute for Health and Clinical Excellence (NICE) have published Clinical Practice Guidelines which include recommendations for management of anaemia in established renal failure.
AIMS
To determine the extent to which the guidelines for anaemia management are met in the UK.
METHODS
Quarterly data (haemoglobin (Hb) and factors that influence Hb) extracts from renal centres in England, Wales and Northern Ireland (EWNI), and annual data from the Scottish Renal Registry for incident and prevalent renal replacement therapy (RRT) cohorts for 2007 were analysed by the UK Renal Registry (UKRR).
RESULTS
In the UK, in 2007 58% of patients commenced dialysis therapy with Hb > or = 10.0 g/dl (median Hb 10.3 g/dl). Of incident patients 81% and 87% had a Hb > or = 10.0 g/dl by 3 and 6 months of dialysis treatment respectively. The median Hb of haemodialysis (HD) patients was 11.6 g/dl with an interquartile range (IQR) of 10.6-12.6 g/dl. Of HD patients 86% had a Hb > or = 10.0 g/dl. The median Hb of peritoneal dialysis (PD) patients in the UK was 11.9 g/dl (IQR 11.0-12.8 g/dl). 91% of UK PD patients had a Hb > or = 10.0 g/dl. The median ferritin in HD patients in EWNI was 417 microg/L (IQR 270-598) and 95% of HD patients had a ferritin > or = 100 microg/L. The median ferritin in PD patients was 255 microg/L (IQR 143-411) with 85% of PD patients having a ferritin > or = 100 microg/L. In EWNI the mean ESA dose was higher for HD than PD patients (9,300 vs. 6,100 IU/week).
CONCLUSIONS
This year for the first time there has been a small fall (from 85.9% in 2006 to 85.6%) in the percentage of HD patients with an Hb of > or = 10 g/dl. This contrasts with previous annual improvements in this figure and is related to implementation of the new Hb Standard which has a target range of 10.5-12.5 g/dl.
背景
英国肾脏协会（RA）和国家卫生与临床优化研究所（NICE）发布了临床实践指南，其中包括对已确诊肾衰竭患者贫血管理的建议。
目的
确定英国贫血管理指南的遵循程度。
方法
英国肾脏注册机构（UKRR）分析了2007年英格兰、威尔士和北爱尔兰（EWNI）肾脏中心的季度数据（血红蛋白（Hb）及影响Hb的因素），以及苏格兰肾脏注册中心针对新发和现患肾脏替代治疗（RRT）队列的年度数据。
结果
在英国，2007年58%开始透析治疗的患者Hb≥10.0g/dl（Hb中位数为10.3g/dl）。新发患者中，分别有81%和87%在透析治疗3个月和6个月时Hb≥10.0g/dl。血液透析（HD）患者的Hb中位数为11.6g/dl，四分位间距（IQR）为10.6 - 12.6g/dl。86%的HD患者Hb≥10.0g/dl。英国腹膜透析（PD）患者的Hb中位数为11.9g/dl（IQR 11.0 - 12.8g/dl）。91%的英国PD患者Hb≥10.0g/dl。EWNI地区HD患者的铁蛋白中位数为417μg/L（IQR 270 - 598），95%的HD患者铁蛋白≥100μg/L。PD患者的铁蛋白中位数为255μg/L（IQR 143 - 411），85%的PD患者铁蛋白≥100μg/L。在EWNI地区，HD患者的促红细胞生成素（ESA）平均剂量高于PD患者（9300 vs. 6100 IU/周）。
结论
今年首次出现Hb≥10g/dl的HD患者比例略有下降（从2006年的85.9%降至85.6%）。这与该数据之前逐年改善的情况形成对比，且与新Hb标准的实施有关，新标准的目标范围为10.5 - 12.5g/dl。
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