Anemia in ESKD Patient (End-Stage Kidney Disease): The Rare Cause Is in the Forefront  

作　　者：Awad Magbri Mariam El-Magbri Pablo Abrego Hernandez Awad Magbri;Mariam El-Magbri;Pablo Abrego Hernandez(Marshfield Medical Center, Weston, USA)

机构地区：[1]Marshfield Medical Center, Weston, USA

出　　处：《Open Journal of Nephrology》2022年第4期382-389,共8页肾脏病（英文）

摘　　要：We reported a case of severe anemia in a patient with end-stage kidney disease (ESKD) on dialysis. The anemia developed when the patient is switched from hemodialysis (HD) to peritoneal dialysis (PD) when the intra-venous erythropoietin stimulating agent (ESA, Epogen) was changed into subcutaneous injection of darbepoetin. The patient’s hemoglobin dropped 2 grams in about two months during this period. Extensive work-up including, bleeding disorders, hemolysis, iron deficiency, infections including CMV, Epstein-Bar virus, parvo-19 virus infection were unrevealing The anti-Epogen neutralizing antibodies were not measured due to unavailability. Bone marrow biopsy and aspirate were negative for infiltrations or myelodysplastic syndrome (MDS). The leukocyte and platelet counts were normal. Even though anti-ESA antibodies were not measured in this case, all tentative causes of his anemia were excluded by laboratory investigations. The patient’s anemia was treated symptomatically with blood transfusion and discontinuation of the ESA treatment. He made a remarkable recovery.We reported a case of severe anemia in a patient with end-stage kidney disease (ESKD) on dialysis. The anemia developed when the patient is switched from hemodialysis (HD) to peritoneal dialysis (PD) when the intra-venous erythropoietin stimulating agent (ESA, Epogen) was changed into subcutaneous injection of darbepoetin. The patient’s hemoglobin dropped 2 grams in about two months during this period. Extensive work-up including, bleeding disorders, hemolysis, iron deficiency, infections including CMV, Epstein-Bar virus, parvo-19 virus infection were unrevealing The anti-Epogen neutralizing antibodies were not measured due to unavailability. Bone marrow biopsy and aspirate were negative for infiltrations or myelodysplastic syndrome (MDS). The leukocyte and platelet counts were normal. Even though anti-ESA antibodies were not measured in this case, all tentative causes of his anemia were excluded by laboratory investigations. The patient’s anemia was treated symptomatically with blood transfusion and discontinuation of the ESA treatment. He made a remarkable recovery.

关 键 词：Pure Red Cell Aplasia (PRCA) ESKD (End-Stage Kidney Disease) HEMODIALYSIS Peritoneal Dialysis Bone Marrow Aspirate and Biopsy Anti-EPO Antibodies Neutralizing Antibodies Myelodysplastic Syndrome 

分 类 号：TP1[自动化与计算机技术—控制理论与控制工程]