Casati S, Campise M, Crepaldi M, Lobo J, Graziani G, Ponticelli C
Divisione di Nefrologia, IRCCS Ospedale Maggiore Policlinico, Milan, Italy.
Nephrol Dial Transplant. 1989;4(8):718-20. doi: 10.1093/ndt/4.8.718.
In 11 chronic haemodialysis patients we investigated whether the increase in haematocrit during recombinant human erythropoietin (rHuEPO) treatment might alter the long-term efficiency of haemodialysis. After correction of anaemia with rHuEPO (mean Ht 35 +/- 2% vs 19 +/- 2% at baseline) (p 0.001), mean predialysis creatinine and urea did not change, while predialysis phosphate (1.77 +/- 0.38 vs 1.51 +/- 0.29 mmol/l) were significantly increased (p 0.01). In six of the 11 rHuEPO treated patients a post- versus pre-dialysis haemoconcentration (haematocrit 44% vs 35%) not attributable to different ultrafiltration regimes, was observed. In these 6 patients mean predialysis phosphate, creatinine and urea tended to be higher, but not significantly, in comparison to he remaining 5 patients who did not haemoconcentrate. Dialyser clearances and total extractions for urea, creatinine, phosphate and inulin were compared to those of 11 matched haemodialysis patients with anaemia. No differences were observed either for small and middle molecule clearances or their extractions between rHuEPO and anaemic patients. In conclusion, dialysis efficiency is not affected if haematocrit values are kept about 35%.
在11例慢性血液透析患者中，我们研究了重组人促红细胞生成素（rHuEPO）治疗期间血细胞比容的增加是否会改变血液透析的长期效率。在用rHuEPO纠正贫血后（平均血细胞比容从基线时的19±2%升至35±2%）（p<0.001），透析前肌酐和尿素均值未改变，而透析前磷酸盐（从1.51±0.29mmol/L升至1.77±0.38mmol/L）显著升高（p<0.01）。在11例接受rHuEPO治疗的患者中，有6例观察到透析后与透析前的血液浓缩情况（血细胞比容从35%升至44%），这并非由不同的超滤方案所致。与其余5例未出现血液浓缩的患者相比，这6例患者的透析前磷酸盐、肌酐和尿素均值往往更高，但差异无统计学意义。将透析器对尿素、肌酐、磷酸盐和菊粉的清除率及总清除量与11例匹配的贫血血液透析患者进行比较。在rHuEPO治疗患者与贫血患者之间，小分子和中分子物质的清除率及其清除量均未观察到差异。总之，如果血细胞比容值维持在约35%，透析效率不受影响。
