Duclos J, Olea C, Aguirre H, Alvarez M C, Salgado M C
Departamento de Nefrología, Hospital Naval de Viña del Mar, Chile.
Rev Med Chil. 1995 Apr;123(4):451-5.
Aiming to know the factors that influenced the use of erythropoietin (EPO) in chronic hemodialysis patients, we retrospectively studied 82 patients (41 male), of whom 15 received EPO. No differences, between patients receiving or not receiving EPO, were found in age (46.9 +/- 25 and 57 +/- 13 years respectively), male/female ratio (9/6 and 32/35 respectively), time on dialysis (36.4 +/- 25.6 and 36.8 +/- 31.8 months respectively), dialysis hours (3.19 +/- 0.6 and 3.33 +/- 0.39 h respectively) and proportion of diabetics (6.6 and 20.8% respectively). Prior to EPO use and compared to untreated patients, treated patients were transfused with a higher frequency (60 vs 22%) and with more units/patients/years (0.12 vs 0.08). Hemoglobin levels at the start of the treatment was similar in treated and untreated patients (8.4 +/- 1.46 vs 8.78 +/- 1.97 g/dl). EPO was indicated in 11 patients due to general symptomatology associated to anemia and in 4 due to cardiac failure or angina. We conclude that EPO treatment is indicated in approximately 18% of patients in dialysis. An adequate dialytic treatment may achieve optimal hemoglobin levels with minimal transfusion requirements and without need of EPO, thus reducing costs.
为了解影响慢性血液透析患者使用促红细胞生成素（EPO）的因素，我们回顾性研究了82例患者（41例男性），其中15例接受了EPO治疗。接受或未接受EPO治疗的患者在年龄（分别为46.9±25岁和57±13岁）、男女比例（分别为9/6和32/35）、透析时间（分别为36.4±25.6个月和36.8±31.8个月）、透析时长（分别为3.19±0.6小时和3.33±0.39小时）以及糖尿病患者比例（分别为6.6%和20.8%）方面均未发现差异。在使用EPO之前，与未治疗的患者相比，接受治疗的患者输血频率更高（60%对22%），且每年每位患者的输血量更多（0.12对0.08单位）。治疗开始时，治疗组和未治疗组患者的血红蛋白水平相似（分别为8.4±1.46 g/dl和8.78±1.97 g/dl）。11例患者因与贫血相关的一般症状而使用EPO，4例因心力衰竭或心绞痛而使用。我们得出结论，约18%的透析患者需要EPO治疗。充分的透析治疗可以在输血需求最小且无需EPO的情况下达到最佳血红蛋白水平，从而降低成本。
