在中国接受维持性血液透析的 HIV 感染患者中，促红细胞生成素和铁治疗贫血：一项横断面研究。

Erythropoietin and iron for anemia in HIV-infected patients undergoing maintenance hemodialysis in China: a cross-sectional study.

机构信息

Department of Nephrology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 611731, China.

School of Automation Engineering, University of Electronic Science and Technology of China, Chengdu, 611731, China.

出版信息

BMC Nephrol. 2022 Feb 8;23(1):60. doi: 10.1186/s12882-022-02693-y.

DOI:10.1186/s12882-022-02693-y

PMID:35135490

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8827246/

Abstract

BACKGROUND

Anemia is a common complication of chronic kidney disease (CKD) and HIV infection. The number of people living with HIV on hemodialysis (HD) is increasing. However, there is no data about anemia and related therapies in this kind of patients in China. We aim to assess the difference in hemoglobin (Hgb) and treatments like erythropoietin and iron between HIV-HD patients and HD patients in Chengdu, China.

METHODS

This cross-sectional study was conducted with data collection from January 2020 to June 2020. Thirty-four HIV-infected HD patients and thirty-five non-HIV-infected HD patients were included. Age, gender, dialysis vintage, single-pool (sp) Kt/V, Hgb, the dose of erythropoietin, ferritin, use of iron preparations, and serum albumin were collected in all patients. Time since HIV diagnosis, counts of CD4 + T cells, HIV RNA, and antiretroviral therapy for HIV infection were collected in HIV-infected patients. T-test, Mann-Whitney U test, and chi-square statistics were applied in SPSS.

RESULTS

The Hgb of HIV-HD and HD groups were 105.70 (95.93-112.08) g/L and 112.00 (93.00-126.00) g/L respectively (P = 0.064). There was a statistically significant higher erythropoietin dosage used in the HIV-HD population (222.55 ± 115.47 U/kg/week) compared to the HIV-negative HD group (161.86 ± 110.31 U/kg/week) (P = 0.029). 16/34 (47.06%) HIV-HD patients and 5/35 (14.29%) HD patients were treated with iron preparations (P = 0.003). The ferritin levels were 316.50 (117.38-589.75) ng/ml and 272.70 (205.00-434.00) ng/ml in HIV-HD and HD groups respectively.

CONCLUSIONS

A higher erythropoietin dosage and a higher probability of iron preparations may be required to maintain Hgb in HIV-HD patients compared with HD patients.

摘要

背景

贫血是慢性肾脏病（CKD）和 HIV 感染的常见并发症。接受血液透析（HD）治疗的 HIV 感染者人数正在增加。然而，目前中国尚无此类患者贫血及其相关治疗的数据。本研究旨在评估中国成都地区 HIV-HD 患者与 HD 患者之间血红蛋白（Hgb）和红细胞生成素（EPO）及铁剂等治疗的差异。

方法

本横断面研究于 2020 年 1 月至 6 月期间采集数据，共纳入 34 例 HIV 感染的 HD 患者和 35 例非 HIV 感染的 HD 患者。所有患者均收集年龄、性别、透析龄、单室（sp）Kt/V、Hgb、EPO 剂量、铁蛋白、铁剂使用情况及血清白蛋白。HIV 感染者还收集 HIV 诊断时间、CD4+T 细胞计数、HIV RNA 及 HIV 感染的抗逆转录病毒治疗情况。采用 SPSS 软件进行 t 检验、Mann-Whitney U 检验和卡方检验。

结果

HIV-HD 组和 HD 组的 Hgb 分别为 105.70（95.93-112.08）g/L 和 112.00（93.00-126.00）g/L（P=0.064）。HIV-HD 组 EPO 剂量明显高于 HD 组（222.55±115.47 U/kg/周比 161.86±110.31 U/kg/周，P=0.029）。34 例 HIV-HD 患者中有 16 例（47.06%）和 35 例 HD 患者中有 5 例（14.29%）接受了铁剂治疗（P=0.003）。HIV-HD 组和 HD 组的铁蛋白水平分别为 316.50（117.38-589.75）ng/ml 和 272.70（205.00-434.00）ng/ml。