Erythropoietin and anemia in the progression of Balkan endemic nephropathy and other renal diseases.
Erythropoietin and anemia in the progression of Balkan endemic nephropathy and other renal diseases.
复制标题
巴尔干地方性肾病和其他肾脏疾病进展中的促红细胞生成素和贫血。
作者：
Pavlović-Kentera,V;Clemons,GK;Trbojević,S;Dimković,N;Djukanović,L
我们调查了三种慢性肾脏疾病（巴尔干半岛的地方性肾病（BEN）、慢性肾盂肾炎（PN）和慢性肾小球肾炎（GN））不同阶段患者的贫血情况。共88例患者的肌酐清除率为9至118 ml/min，血红蛋白浓度为70至160 g/l，研究了促红细胞生成素产生与肾病类型和分期之间的关系（如果有）。BEN中的贫血是一个特别关注的焦点，因为已经指出，在BEN中，贫血先于肾衰竭。我们的数据既不能证明也不能反驳这一说法。在所有三种肾病中，肌酐清除率和血红蛋白浓度之间存在显著的正相关性，这表明在研究的患者中，无论基础疾病如何，贫血的严重程度都会随着肾功能损害而增加。免疫反应性促红细胞生成素的血清水平在正常范围内的54例，中度增加20和轻微下降14。促红细胞生成素水平似乎与肾衰竭的阶段或肾病类型无关。唯一的例外是肾小球肾炎和肾功能正常的患者血清促红细胞生成素水平升高，红细胞浓度参数显著高于同一亚组的肾小管间质性肾病患者。在严重肾功能衰竭和贫血患者中，血清促红细胞生成素水平与贫血程度不相称地低，表明促红细胞生成素在贫血的发病机制中起作用。
We have investigated anemia in patients at different stages of the evolution of three chronic renal diseases: Balkan endemic nephropathy (BEN), chronic pyelonephritis (PN) and chronic glomerulonephritis (GN). A total of 88 patients with creatinine clearances from 9 to 118 ml/min and hemoglobin concentrations from 70 to 160 g/l were studied with regard to the relationship, if any, between erythropoietin production and the type and stage of nephropathy. Anemia in BEN was a particular focus of interest since it had been stated that in BEN, anemia precedes renal failure. Our data neither prove nor disprove this statement. A significant positive correlation between creatinine clearance and hemoglobin concentration was found in all three nephropathies, indicating that in the patients studied the severity of anemia increased with the impairment of renal function regardless of the underlying disease. Serum levels of immunoreactive erythropoietin were in the normal range in 54 patients, moderately increased in 20 and slightly decreased in 14. The erythropoietin level appears to be unrelated to the stage of renal failure or the type of nephropathy. The only exception was the subgroup where the patients with glomerulonephritis and normal renal function had increased serum erythropoietin levels and significantly higher parameters of red blood cell concentration than the patients from the same subgroup with tubulointerstitial nephropathies. In patients with severe renal failure and anemia, serum erythropoietin levels were inappropriately low for the degree of anemia, indicating that erythropoietin plays a role in the pathogenesis of the anemia.