Vanrenterghem Y, Vanwalleghem J
Department of Nephrology, University Hospital Gasthuisberg, Leuven, Belgium.
Nephrol Dial Transplant. 1998;13 Suppl 2:13-5. doi: 10.1093/ndt/13.suppl_2.13.
The possibility of lower efficacy and the fear of an increased incidence of side effects may explain the reluctance to use recombinant human erythropoietin (r-HuEPO) in patients with impaired renal function who do not yet require dialysis, as well as in transplanted patients with a failing renal allograft. Several recent studies have clearly shown that r-HuEPO is effective in these patient populations and that the doses needed to control anaemia are comparable with or lower than those needed for dialysis patients. When started at a low dose, the risk of severe hypertension is minimal, although in a significant number of patients intensification of the antihypertensive regimen is needed. Moreover, there are no indications that the use of r-HuEPO accelerates the deterioration of residual renal function.
疗效降低的可能性以及对副作用发生率增加的担忧，可能解释了为何不愿在尚未需要透析的肾功能受损患者以及肾移植失败的移植患者中使用重组人促红细胞生成素（r-HuEPO）。最近的几项研究清楚地表明，r-HuEPO在这些患者群体中是有效的，控制贫血所需的剂量与透析患者相当或更低。从低剂量开始使用时，严重高血压的风险极小，尽管相当多的患者需要加强抗高血压治疗方案。此外，没有迹象表明使用r-HuEPO会加速残余肾功能的恶化。
