Hematologic aspects of end-stage renal failure
Hematologic aspects of end-stage renal failure
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终末期肾衰竭的血液学方面
作者：
P. Zachée;J. Vermylen;M. Boogaerts
肾功能不全可引起多种血液学紊乱，包括贫血、白细胞功能障碍和凝血功能障碍。肾功能衰竭的贫血被归因于红细胞生成素的相对缺乏，但铁或叶酸的绝对缺乏也可能起作用。其他影响因素包括重金属毒性、失血和有毒自由基诱导的红细胞存活率降低。随着重组人促红细胞生成素的开发，肾脏疾病贫血的治疗取得了进展。在选定的患者中，每三周皮下注射50-75 IU/kg剂量，目前血红蛋白正常化是可能的。肾脏疾病的凝血功能障碍包括获得性血小板质量缺陷，最好的治疗方法是透析，但也可以通过rHuEPO、冷沉淀或DDAVP和结合雌激素成功治疗。尿毒症诱导的白细胞功能障碍包括减少粒细胞趋化性，吞噬作用，和杀菌活性。细胞介导的免疫缺陷和低丙种球蛋白血症也有描述。尿毒症的血液学表现的病理生理进行了讨论。治疗建议处理贫血，出血，感染并发症的肾功能衰竭。
SummaryRenal dysfunction may give rise to a variety of hematologic disturbances, including anemia, leukocyte dysfunction, and coagulopathy. The anemia of renal failure has been attributed to a relative deficiency of erythropoietin, but absolute deficiencies of iron or folate may also play a role. Other contributing factors include heavy-metal toxicity, blood loss, and a reduction in red cell survival induced by toxic radicals. The treatment of the anemia of renal disease has advanced with the development of recombinant human erythropoietin. At subcutaneous doses of 50–75 IU/kg triweekly in selected patients, normalization of hemoglobin is presently possible. The coagulopathy of renal disease consists of an acquired qualitative platelet defect, best remedied by dialysis but also treated successfully by rHuEPO, cryoprecipitate or DDAVP, and conjugated estrogens. Uremia-induced leukocyte dysfunctions include diminished granulocyte chemotaxis, phagocytosis, and bactericidal activity. Cell-mediated immune defects and hypogammaglobulinemia have also been described. The pathophysiology of the hematologic manifestations of uremia is discussed. Therapeutic recommendations for dealing with anemia, bleeding, and infectious complications of renal failure are described.
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影响因子：
56.9
作者：
GOLDBERG, MA;DUNNING, SP;BUNN, HF
通讯作者：
BUNN, HF
影响因子：
3.8
作者：
J. Solomkin;Jenkins Mk;R. Nelson;D. Chenoweth;R. L. Simmons
通讯作者：
J. Solomkin;Jenkins Mk;R. Nelson;D. Chenoweth;R. L. Simmons
透析过程中粒细胞 LAM-1 和 MAC-1 的调节——一项前瞻性、随机对照试验。
影响因子：
19.6
作者：
Himmelfarb,J;Zaoui,P;Hakim,R
通讯作者：
Hakim,R
不适当的激活、失活和可能的自氧化损伤是创伤中中性粒细胞运动缺陷的机制。
DOI：
10.1093/infdis/154.3.471
发表时间：
1986
期刊：
The Journal of infectious diseases
影响因子：
--
作者：
Maderazo,EG;Woronick,CL;Albano,SD;Breaux,SP;Pock,RM
通讯作者：
Pock,RM