摘要
目的观察腹膜透析患者从红细胞生成刺激剂(erythropoiesis stimulating agents,ESA)转换为新型的口服低氧诱导因子-脯氨酰羟化酶抑制剂罗沙司他的疗效和安全性。方法选取2019年7月至2020年5月在北京大学国际医院透析中心应用ESA治疗贫血的维持性腹膜透析的患者。根据体重制定罗沙司他起始剂量,根据血红蛋白变化调整剂量,血红蛋白靶目标值100~130 g/L,观察24周。期间口服铁剂补铁治疗。记录血压、血脂、铁代谢等相关指标的变化,及相关不良反应。结果入组共20例腹膜透析患者,入组前的血红蛋白为(110.1±7.8)g/L,均使用α型ESA平均剂量为(5100.0±2284.2)U/周。转换为罗沙司他治疗后16例(80%)患者血红蛋白涨幅>10 g/L,罗沙司他治疗贫血反应性良好。逐步调整罗沙司他治疗的平均剂量为(216.6±102.6)/周,患者血红蛋白达标率可达95%,平均血红蛋白水平为(113.7±9.3)g/L。结论从ESA转换罗沙司他治疗肾性贫血,腹膜透析患者对罗沙司他有很好的反应性,通过剂量调整能够有效维持血红蛋白达到靶目标值范围。
Objective To observe the efficacy and safety of maintenance peritoneal dialysis patients who switched from erythropoiesis stimulating agents(ESA)to a new oral hypoxia-inducible factor proline hydroxylase inhibitor Roxadustat.Methods The patients who received peritoneal dialysis from July 2019 to May 2020 in Peking University International Hospital were included.They were treated anemia with ESA.Roxadustat was given and the initial dose was decided according to body weight and the dose was adjusted based on Hb changes.The target hemoglobin value was se tat 100-130 g/L,and the observation was conducted for 24 weeks.Oral iron supplementation was permitted.Record changes in blood pressure,blood lipids,iron metabolism and other related indicators,and record related adverse reactions.Results A total of 20 peritoneal dialysis patients were enrolled.The hemoglobin before enrollment was(110.1±7.8)g/L.The average dose ofα-type ESA was(5100.0±2284.2)U/week.The increase in hemoglobin level was greater than 10 g/L in 16 patients who were converted to Roxadustat for treatment.The patients had a good response to Roxadustat for anemia.When the average dose of Roxadustat was gradually adjusted to(216.6±102.6)/week,the patient's hemoglobin compliance rate was 95%,and the average hemoglobin concentration was(113.7±9.3)g/L.Conclusion Switching from ESA to Roxadustat to treat renal anemia,the patients with peritoneal dialysis have a good response to Roxadustat.Through dose adjustment,hemoglobin can be effectively maintained at the target value.
作者
甘红兵
丁嘉祥
任晓英
方晓完
王梅
GAN Hong-bing;DING Jia-xiang;REN Xiao-ying;FANG Xiao-wan;WANG Mei(Peritoneal Dialysis Center,Department of Nephrology,Peking University International Hospital,Beijing 102206,China)
出处
《中国实用内科杂志》
CAS
CSCD
北大核心
2020年第11期937-941,共5页
Chinese Journal of Practical Internal Medicine
