Hyporesponsiveness to Erythropoietin: Causes an Management
Hyporesponsiveness to Erythropoietin: Causes an Management
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DOI：
10.1053/j.ackd.2008.12.004
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发表时间：
2009-03-01
影响因子：
2.9
通讯作者：
Agarwal, Rajiv
中科院分区：
文献类型：
--
作者：
Elliott, James;Mishler, Dennis;Agarwal, Rajiv
在慢性肾病患者中，促红细胞生成素抵抗是常见的，昂贵的，并且具有超出贫血管理的影响，因为促红细胞生成素抵抗的存在预示着致命的结果。探讨红细胞生成素抵抗的起源可能有助于考虑铁限制性红细胞生成，炎症和骨髓抑制的发病三联体。由于难以解释铁缺乏症的测试而难以诊断，在需要高剂量促红细胞生成素的患者中应考虑铁限制性红细胞生成，具有低转铁蛋白饱和度（例如，
In patients with chronic kidney disease, erythropoietin resistance is common, costly, and has implications beyond the management of anemia because the presence of erythropoietin resistance portends mortal outcomes. Exploring the provenance of erythropoietin resistance may be facilitated by the consideration of the pathogenetic triad of iron-restricted erythropoiesis, inflammation, and bone marrow suppression. Challenging to diagnose because of difficulty in interpreting tests of iron deficiency, iron-restricted erythropoiesis should be considered in patients who require high doses of erythropoietin, have low transferrin saturation (eg,