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[透析前患者(1-4期)慢性肾脏病贫血的治疗]

[Treatment anaemia of chronic kidney disease in predialysis patients (stage 1-4)].

作者信息

Lovcić Vesna, Vujić Jovana, Ivanac Janković Renata, Basić-Jukić Nikolina, Barisić Ivan, Lovcić Petra, Dzapo Marko

机构信息

Centar za dijalizu Internog odjela Opce bolnice Bjelovar.

出版信息

Acta Med Croatica. 2009 Sep;63 Suppl 1:11-6.

Abstract

Anemia is the most frequent haematological problem of chronic kidney disease (CKD). It begins in early stage of CKD and worsens with disease progression, affecting nearly all of predialysis patients. It is usually asymptomatic, therefore is underdiagnosed and undertreated. Anemia of CKD is predominantly a result of abnormal erythropoietin (EPO) production and iron deficiency. Renal anemia is associated with an increased risk of ischemic heart disease, left ventricular hypertrophy, chronic heart failure and higher cardiovascular morbidity and mortality. Patients et risk for CKD should be more often monitored for early detection of anemia so they could start with treatment on time. Recent studies show that erythropoeisis-stimulating agents (ESAs) are effective in predialysis especially if used with antihypertensive agents and statin. Correcting anemia in early stage kidney disease may delay progression to end-stage kidney disease (ESRD) and prolong time to start dialysis. Improved cardiac function in those patients reduce morbidity and mortality risk and improve quality of life (QoL) in patients with CKD.

摘要

贫血是慢性肾脏病(CKD)最常见的血液学问题。它始于CKD早期,并随疾病进展而恶化,几乎影响所有透析前患者。它通常无症状,因此诊断不足且治疗不足。CKD贫血主要是促红细胞生成素(EPO)产生异常和缺铁的结果。肾性贫血与缺血性心脏病、左心室肥厚、慢性心力衰竭风险增加以及更高的心血管发病率和死亡率相关。CKD风险患者应更频繁地监测以早期发现贫血,以便他们能够及时开始治疗。最近的研究表明,促红细胞生成素(ESA)在透析前有效,特别是与抗高血压药物和他汀类药物联合使用时。早期肾病纠正贫血可能会延迟进展至终末期肾病(ESRD),并延长开始透析的时间。这些患者心脏功能的改善降低了发病率和死亡风险,并改善了CKD患者的生活质量(QoL)。

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