[ACC2012]合并CKD的高血压患者的治疗方案——Dr. Suzanne Oparil 专访
<International Circulation>: Once kidney function has deteriorated to the point of dialysis, there are problems with anemia. How is renal anemia handled?
《国际循环》:一旦患者的肾功能下降到需要透析的时候,患者就会出现贫血,我们是如何治疗肾性贫血的呢?
Dr Oparil: The treatment is erythropoietin. However, this has been over-emphasized as well, because if you administer erythropoietin to a patient who doesn’t really need it, you can get too many red blood cells and resultant hypercoagulation and cardiovascular events, so the field has backed off somewhat on its use. It’s a complicated issue. Erythropoietin stimulates the bone marrow and erythropoiesis to increase red blood cells. The aim however would not be to get the red cell count up to normal levels but to be satisfied with some degree of anemia. It is safer that way.
Dr Oparil: 我们治疗肾性贫血的方法是使用促红素。然而,这种治疗现在已经被过分强调,所以,我们可能给并不需要这种治疗的患者使用促红素。在这种情况下,患者的红细胞会太多并随后出现高凝状态而发生心血管事件,因此用促红素治疗目前已经不那么被过分强调了。这是个非常复杂的问题。促红素刺激骨髓从而增加红细胞的数量。虽然我们的目标并不是要把患者的红细胞数量提高到正常水平,但是我们还是需要这种治疗来缓解一定程度的贫血。这样的治疗才比较安全。
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