Author/Editor     Malovrh, Marko
Title     Zdravljenje renalne anemije z eritropoetinom in železom: lastne izkušnje
Translated title     The treatment of renal anemia with erythropoetin and iron: personal experiences
Type     članek
Source     In: Križman I, editor. Interna medicina 2005: novosti in aktualnosti. Zbornik predavanj 2. kongres Združenja internistov SZD; 2005 okt 21-22; Ljubljana. Ljubljana: Slovensko zdravniško društvo, Združenje internistov,
Publication year     2005
Volume     str. 131-7
Language     slo
Abstract     In patients with renal failure, severe anaemia has a significant impact on the quality of life. Anaemia also represents an important etiological factor in the development of left ventricular hypertrophy. An inadequate production of a glycoprotein hormone, erythropoietin (EPO), is the major cause of anaemia in presence of a reduction in the glomerular filtration rate. EPO is the primary regulator of the growth and survival of the erythroid progenitor. The treatment of anaemia in chronic renal failure has been revolutionized by the introduction of recombinant human EPO. The vast majority of patients respond very well to the treatment, although 5-10% of patients show some resistance to EPO, the most common cause for which is iron deficiency. Several studies have recently been started in order to investigate the effects of preventing renal anaemia from ever developing in uremic patients. Authors present the study of subcutaneous compared with intravenous epoetin in patients receiving haemodialysis, where changing the route of administration of epoetin alpha or beta from s.c. to i.v. required an insignificant dosage increase. In another study they found that low-dose but frequent i.v. iron supplementation allows iron depleted patients to reach or maintain target haemoglobin of 120 g/l at lower EPO requirements and meticulous follow-up with frequent adjustments of therapy is mandatory to avoid either over- or under-dosing of i.v. iron with consequent overloading or depletion of body iron stores. There is intradialytic increment of haemoglobin as adverse effect of ultrafiltration. Decreasing of haemoglobin level reflects a "true effective" haemoglobin level of haemodialysis patients. This is very important for treatment with eritropoetin and target haemoglobin levels.
Descriptors     KIDNEY FAILURE, CHRONIC
ANEMIA
ERYTHROPOIETIN, RECOMBINANT
IRON
TRANSFERRIN
HEMOGLOBINS
TREATMENT OUTCOME