Zehnder C, Glück Z, Descoeudres C, Uehlinger D E, Blumberg A
Department für Innere Medizin, Kantonsspital Aarau, Switzerland.
Nephrol Dial Transplant. 1988;3(5):657-60. doi: 10.1093/oxfordjournals.ndt.a091723.
Twelve anaemic patients on haemodialysis were treated with recombinant human erythropoietin, starting with 72 IU/kg/week. The dose was doubled after 2 weeks until an increase of 2 g/dl of haemoglobin was observed. The effects on various parameters were studied during a 3-month period. Haemoglobin increased from 6.70 +/- 0.74 to 10.49 +/- 1.04 g/dl (mean +/- SD, P less than 0.001), potassium from 5.51 +/- 0.50 to 6.06 +/- 0.65 mmol/l (P less than 0.005), phosphate from 1.78 +/- 0.40 to 2.17 +/- 0.40 mmol/l (P less than 0.001) and the calcium phosphorus product from 4.3 to 5.2 (P less than 0.001). Three patients developed marked periarticular inflammation due to calcified deposits with a high calcium-phosphorus product of 6.8. An increase in arterial blood pressure was observed in three previously well-controlled hypertensive patients, one of whom developed hypertensive encephalopathy. We conclude that recombinant human erythropoietin is very effective in treating the anaemia of end-stage renal failure on haemodialysis. Regular estimations of serum potassium and phosphate are mandatory. In hypertensive individuals a further increase in blood pressure is possible.
12名接受血液透析的贫血患者接受了重组人促红细胞生成素治疗，起始剂量为72国际单位/千克/周。2周后剂量加倍，直至血红蛋白升高2克/分升。在3个月的时间内研究了其对各项参数的影响。血红蛋白从6.70±0.74克/分升升至10.49±1.04克/分升（均值±标准差，P<0.001），钾从5.51±0.50毫摩尔/升升至6.06±0.65毫摩尔/升（P<0.005），磷酸盐从1.78±0.40毫摩尔/升升至2.17±0.40毫摩尔/升（P<0.001），钙磷乘积从4.3升至5.2（P<0.001）。3名患者因钙磷乘积高达6.8的钙化沉积而出现明显的关节周围炎症。3名之前血压控制良好的高血压患者出现动脉血压升高，其中1名发生了高血压脑病。我们得出结论，重组人促红细胞生成素在治疗血液透析的终末期肾衰竭贫血方面非常有效。必须定期测定血清钾和磷酸盐。高血压患者的血压可能会进一步升高。
