Djukanović Lj, Lezaić V
Institute of Urology and Nephrology, Clinical Centre of Serbia, Belgrade.
Srp Arh Celok Lek. 1996 Mar-Apr;124(3-4):93-7.
The discovery of recombinant human erythropoietin has enabled treatment of anaemia in patients whose anaemia was primarily caused by the lack of erythropoietin. This agent was most widely used in the treatment of anaemia in chronic renal failure patients. Non-regulated hypertension is considered to be the only absolute contraindication for recombinant human erythropoietin application, but thrombocytosis, predisposition to thromboses of arterio-venous fistulae, and convulsions are regarded as relative contraindications. Recombinant human erythropoietin may be administered intravenously, but the subcutaneous route is considered more rational. The treatment is initiated by low doses with gradual dose increase, what enables gradual anaemia correction and prevents the appearance of adverse effects. Haemoglobin level of around 100 g/l is considered the target haemoglobin level. The majority of patients respond well to treatment by human recombinant erythropoietin and the absence of anaemia improvement may be the result of iron deficiency, occult haemorrhages, chronic infection, inadequate dialysis, secondary hyperparathyroidism, aluminium intoxication. Anaemia improvement during the treatment with recombinant erythropoietin leads to the improvement of function of most organs and the quality of life in general as well as avoidance of blood transfusions and their adverse effects. The most frequent adverse effect of recombinant erythropoietin is the development of iron deficiency or hypertension aggravation.
重组人促红细胞生成素的发现，使主要因促红细胞生成素缺乏而导致贫血的患者得以接受贫血治疗。该药物最广泛用于治疗慢性肾衰竭患者的贫血。未控制的高血压被认为是应用重组人促红细胞生成素的唯一绝对禁忌证，但血小板增多症、动静脉瘘血栓形成倾向和惊厥被视为相对禁忌证。重组人促红细胞生成素可静脉给药，但皮下给药途径被认为更为合理。治疗从低剂量开始，逐渐增加剂量，这样既能逐渐纠正贫血，又能防止出现不良反应。血红蛋白水平约100g/L被视为目标血红蛋白水平。大多数患者对重组人促红细胞生成素治疗反应良好，贫血无改善可能是缺铁、隐匿性出血、慢性感染、透析不充分、继发性甲状旁腺功能亢进、铝中毒所致。重组促红细胞生成素治疗期间贫血的改善会使大多数器官的功能和总体生活质量得到改善，同时避免输血及其不良反应。重组促红细胞生成素最常见的不良反应是缺铁的发生或高血压加重。
