Rahbar Maryam, Chitsazian Zahra, Abdoli Firoozeh, Moeini Taba Seyed-Masoud, Akbari Hosein
Department of Nephrology, Tehran University of Medical Sciences, Tehran, Iran.
Department of Internal Medicine, Kashan University of Medical Sciences, Kashan, Iran.
J Nephropathol. 2017 Jan;6(1):25-29. doi: 10.15171/jnp.2017.05. Epub 2016 Aug 22.
Anemia is a common complication of chronic renal failure due to reduce erythropoietin production by kidneys. Anemia treated with recombinant human erythropoietin (rHu-EPO). Pure red cell aplasia (PRCA) due to antibody productionagainst rHu-EPO is a rare but major complication of this drug.
The aim of this study was to determine the prevalence of PRCA due to antibodies in dialysis patients with resistant anemia who received erythropoietin.
We studied 128 under maintenance hemodialysis patients more than 3 month in Kashan. In patients with anemia who received erythropoietin with dose requirements based on weight and anemia and without any another cause for anemia, evaluate for PRCA and anti-rHu-EPO antibody level were measured by ELISA.
In this research, 75 patients (58.6%) were male and 53 patients (41.4%) were female. The mean age of the patients was 59.05 ± 16.66 years. The result of analysis showed that 55 (43%) patients had anemia with hemoglobin level less than 10 mg/dL. Only 3 patients had PRCA and antibodies against erythropoietin in serum. There were no correlation between age, gender, cause of renal failure, hemodialysis duration, hemoglobin level, rHu-EPO dose and levels of anti-rHu-EPO antibody serum value.
The result of this study indicated that administration of rHu-EPO in dialysis patients afflicted to kidney failure may cause PRCA especially through intravenous injection. However, this change is not statistically significant.
贫血是慢性肾衰竭的常见并发症，原因是肾脏产生促红细胞生成素减少。贫血采用重组人促红细胞生成素（rHu-EPO）治疗。因产生抗rHu-EPO抗体导致的纯红细胞再生障碍性贫血（PRCA）是该药物罕见但主要的并发症。
本研究旨在确定接受促红细胞生成素治疗的难治性贫血透析患者中因抗体导致的PRCA患病率。
我们研究了 Kashan 地区 128 例维持性血液透析超过 3 个月的患者。对于接受根据体重和贫血情况调整剂量的促红细胞生成素治疗且无其他贫血原因的贫血患者，评估是否患有 PRCA，并通过 ELISA 检测抗 rHu-EPO 抗体水平。
本研究中，75 例患者（58.6%）为男性，53 例患者（41.4%）为女性。患者的平均年龄为 59.05 ± 16.66 岁。分析结果显示，55 例（43%）患者血红蛋白水平低于 10 mg/dL，存在贫血。血清中仅有 3 例患者患有 PRCA 且存在抗促红细胞生成素抗体。年龄、性别、肾衰竭病因、血液透析时长、血红蛋白水平、rHu-EPO 剂量与抗 rHu-EPO 抗体血清值水平之间均无相关性。
本研究结果表明，肾衰竭透析患者使用 rHu-EPO 可能会导致 PRCA，尤其是通过静脉注射。然而，这种变化在统计学上并不显著。
