Frenken L A, Verberckmoes R, Michielsen P, Koene R A
Department of Medicine, University Hospital, Nijmegen, the Netherlands.
Nephrol Dial Transplant. 1989;4(9):782-6.
Recombinant-human erythropoietin (r-HuEPO) was administered to 24 anaemic pre-dialysis patients with end-stage renal disease. R-HuEPO was injected i.v. three times weekly during the first two months (correction phase). Fixed dosages of 50 U/kg, 100 U/kg, and 150 U/kg were used, and each dose group consisted of eight patients. During the subsequent six months r-HuEPO was given once weekly and the dose was adjusted to maintain a stable haemoglobin value (maintenance phase). The mean +/- SD haemoglobin increased from 9.3 +/- 0.6 to 11.1 +/- 1.3 g/dl with 50 U/kg, from 7.9 +/- 1.4 to 11.8 +/- 1.7 g/dl with 100 U/kg and from 8.4 +/- 1.0 to 12.1 +/- 1.1 g/dl with 150 U/kg of r-HuEPO. The two highest dose groups showed a marked reticulocytosis and a transient thrombocytosis. During the maintenance phase haemoglobin remained stable (11.9 +/- 1.1 g/dl) at a mean dose of 199 +/- 139 U/kg of r-HuEPO per week. Blood pressure did not increase, but in nine of eighteen previously hypertensive patients antihypertensive medication was increased. One hypertensive patient developed seizures. No accelerated progression of renal failure could be demonstrated. All patients reported an improved sense of well-being. R-HuEPO is an important new therapeutic agent for the treatment of anaemia of end-stage renal failure that is also effective in pre-dialysis patients.
对24例患有终末期肾病的贫血性透析前患者给予重组人促红细胞生成素（r-HuEPO）。在前两个月（纠正期），r-HuEPO通过静脉注射，每周3次。使用50 U/kg、100 U/kg和150 U/kg的固定剂量，每个剂量组由8名患者组成。在随后的6个月中，r-HuEPO每周给药1次，并调整剂量以维持稳定的血红蛋白值（维持期）。使用50 U/kg的r-HuEPO时，平均±标准差血红蛋白从9.3±0.6增加到11.1±1.3 g/dl；使用100 U/kg时，从7.9±1.4增加到11.8±1.7 g/dl；使用150 U/kg时，从8.4±1.0增加到12.1±1.1 g/dl。两个最高剂量组出现明显的网织红细胞增多和短暂的血小板增多。在维持期，血红蛋白以每周平均199±139 U/kg的r-HuEPO剂量保持稳定（11.9±1.1 g/dl）。血压没有升高，但18例先前患有高血压的患者中有9例增加了抗高血压药物的用量。1例高血压患者发生癫痫发作。未发现肾衰竭加速进展的情况。所有患者均报告幸福感有所改善。r-HuEPO是治疗终末期肾衰竭贫血的一种重要新型治疗药物，对透析前患者也有效。
