Kulzer P, Schaefer R M, Krahn R, Schaefer L, Heidland A
Department of Internal Medicine, University of Wuerzburg, Germany.
Int J Artif Organs. 1994 Apr;17(4):195-202.
Seventy-five non-dialized patients with chronic renal failure (CRF) and severe renal anemia were enrolled in a study, receiving r-HuEPO subcutaneously thrice weekly for 6 months. In 64 patients (85%) 7 weeks of treatment with a weekly dose of 158 U/kg were required to achieve Hb concentrations within the target range of 10 to 12 g/dl. Of the 11 patients (15%) who failed to achieve the target Hb range, none were considered to be non-responders as they were excluded for unrelated reasons prior to week 16 (8 cases), or were iron deficient (2 cases), or had bleeding complications (1 patient). Maintaining the Hb concentration at a level of 10.5 g/dl required a mean r-HuEPO dose of 92 U/kg per week. Adverse events were generally mild or moderate. The most commonly reported were hypertension (8%), viral infection/including flu-like syndrome (7%), nausea (7%), and dizziness (5%). Statistically significant increases in mean creatinine concentrations observed after 12 and 24 weeks were most likely due to the progression of renal disease. These results confirm that 50 U/kg of r-HuEPO given 3 times per week subcutaneous provide a safe and effective therapy for anemic predialysis patients.
75例非透析慢性肾衰竭(CRF)合并严重肾性贫血患者纳入一项研究,皮下注射重组人促红细胞生成素(r-HuEPO),每周3次,共6个月。64例患者(85%)需要每周158 U/kg剂量治疗7周,以使血红蛋白(Hb)浓度达到10至12 g/dl的目标范围。11例患者(15%)未达到目标Hb范围,其中无1例被视为无反应者,因为在第16周之前,8例因无关原因被排除,2例缺铁,1例有出血并发症。将Hb浓度维持在10.5 g/dl水平,r-HuEPO平均每周剂量为92 U/kg。不良事件一般为轻度或中度。最常报告的是高血压(8%)、病毒感染/包括类流感综合征(7%)、恶心(7%)和头晕(5%)。12周和24周后观察到的平均肌酐浓度有统计学意义的升高很可能是由于肾脏疾病的进展。这些结果证实,每周3次皮下注射50 U/kg的r-HuEPO为贫血的透析前患者提供了一种安全有效的治疗方法。