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作 者:顾琳[1] 夏春英[1] 邵维斌[1] GU Lin;XIA Chunying;SHAO Weibin(Department of Nephrology,Affiliated People's Hospital of Jiangsu University,Zhenjiang212002,China)
机构地区:[1]江苏大学附属人民医院肾内科,江苏镇江212002
出 处:《中国现代医生》2021年第7期162-165,共4页China Modern Doctor
摘 要:肾性贫血是终末期肾病常见并发症,肾性贫血传统治疗药物一般是促红细胞生成素(Erythropoietin,EPO)及其类似物,同时包括铁剂、维生素B12、叶酸等,而传统用药具有其局限性,如EPO在上世纪八九十年代大规模运用于临床,虽然很大程度上改善了慢性肾脏病(chronic kidney diseas,CKD)合并肾性贫血患者的预后,但仍有部分患者对EPO存在抵抗,同时长期使用EPO会增加高血压及血管栓塞等不良后果,而静脉补铁也存在呼吸困难、心肌梗死及过敏等风险。罗沙司他作为低氧诱导因子脯氨酰羟化酶抑制剂(Hypoxia inducible factor prolyl hydroxylase inhibitor,HIF-PHI)是一种治疗肾性贫血的全新药物,有可能避免传统疗法的局限性。目前本血液净化中心研究1例血液透析合并肾性贫血患者使用EPO及铁剂效果不佳故而改用罗沙司他。Renal anemia is a common complication of end-stage renal disease.The traditional treatment of renal anemia is generally erythropoietin(EPO)and its analogs,including iron,vitamin B12,and folic acid.While traditional drugs had their limitations.For example,EPO was widely used in clinics in the 1980s and 1990s.Although it has greatly improved the prognosis of patients with chronic kidney disease(CKD)and renal anemia,there are still some patients who are resistant to EPO.At the same time,long-term use of EPO will increase the adverse effects of high blood pressure and vascular embolism.Intravenous iron supplementation also has the risk of dyspnea,myocardial infarction,and allergies.Roxastat,as a hypoxia inducible factor prolyl hydroxylase inhibitor(HIF-PHI),is a new drug for the treatment of renal anemia,which may avoid the limitations of traditional therapies.At present,a case of hemodialysis complicated with renal anemia in our blood purification center changed to Roxastat because of the poor effect of using EPO and iron.The introduction is as follows.
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