Vereerstraeten A, Gastaldello K, Gervy C, Vanherweghem J L, Tielemans C
Department of Nephrology, Dialysis, and Transplantation, Hôpital Erasme, Université Libre de Bruxelles, Belgium.
Nephrol Dial Transplant. 1994;9(2):189-91.
Three patients on chronic maintenance haemodialysis have progressively increased their haematocrit to reach values between 40 and 45%, a situation associated with an increased risk of thrombosis of their arteriovenous fistulae. Two of them had been submitted to repeated phlebotomies, which remained unsuccessful despite the induction of a profound iron deficiency in one of them. Hence, a trial with oral theophylline was performed in the three patients, resulting in a sustained decrease of the haematocrit (from 43.6 to 33%) and endogenous erythropoietin (from 46 to 15 mU/ml) levels. In two patients, theophylline therapy was stopped transiently due to gastrointestinal side-effects, which resulted in a rapid return to previous haematocrit levels; rechallenge with a better tolerated preparation, however, was efficient again. We conclude that oral theophylline appears to be an efficient treatment to control too high haematocrit levels in dialysis patients.
三名接受慢性维持性血液透析的患者逐渐提高了他们的血细胞比容，达到了40%至45%之间的值，这种情况与他们动静脉内瘘血栓形成风险增加有关。其中两名患者接受了反复放血治疗，尽管其中一名患者出现了严重缺铁，但治疗仍未成功。因此，对这三名患者进行了口服茶碱试验，结果血细胞比容（从43.6%降至33%）和内源性促红细胞生成素（从46降至15 mU/ml）水平持续下降。在两名患者中，由于胃肠道副作用，茶碱治疗暂时停止，结果血细胞比容迅速恢复到先前水平；然而，用耐受性更好的制剂再次激发治疗再次有效。我们得出结论，口服茶碱似乎是控制透析患者过高血细胞比容水平的有效治疗方法。
