Żebrowski Paweł, Mieczkowski Mariusz
Katedra i Klinika Nefrologii, Dializoterapii i Chorób Wewnętrznych WUM, Warszawa, Polska,
Katedra i Klinika Nefrologii, Dializoterapii i Chorób Wewnętrznych WUM, Warszawa, Polska.
Wiad Lek. 2016;69(5):753-755.
Erythropoietin (EPO) deficiency is important complication of chronic kidney disease. It downregulates red cells maturation and production causing renal anemia. It is associated with reduced quality of life, increased risk of blood transfusions and cardiovascular morbidity. It is possible to substitute EPOwith recombinant human EPOor its derivatives - erythropoiesis stimulating agents (ESA). ESA therapy reduces blood transfusions, improves quality of life and can raise hemoglobin to 10-11.5 g/dl. Higher hemoglobin targets bring more harm than benefit - including increased risk for stroke, hypertension and vascular access thrombosis and mortality. Initiation of ESA therapy should be preceded by excluding the other causes of anemia and balancing ESA advantages and disadvantages in every patient. In patients with previous stroke, previous or current malignancy risks of ESA therapy may outweigh the risks of red cell transfusions.
促红细胞生成素（EPO）缺乏是慢性肾脏病的重要并发症。它会下调红细胞的成熟和生成，导致肾性贫血。它与生活质量下降、输血风险增加以及心血管疾病发病率升高有关。可以用重组人促红细胞生成素或其衍生物——促红细胞生成素刺激剂（ESA）来替代促红细胞生成素。ESA治疗可减少输血次数，改善生活质量，并可将血红蛋白水平提高到10 - 11.5 g/dl。更高的血红蛋白目标带来的危害大于益处——包括中风、高血压、血管通路血栓形成和死亡风险增加。在开始ESA治疗之前，应排除贫血的其他原因，并权衡每位患者使用ESA的利弊。对于既往有中风史、有既往或当前恶性肿瘤的患者，ESA治疗的风险可能超过红细胞输血的风险。
