Racial variations in erythropoietic response to epoetin alfa in chronic kidney disease and the impact of smoking.
Racial variations in erythropoietic response to epoetin alfa in chronic kidney disease and the impact of smoking.
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慢性肾脏病中红细胞生成素阿尔法反应的种族差异以及吸烟的影响。
DOI：
10.1093/ndt/gfi128
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发表时间：
2005
期刊：
影响因子：
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通讯作者：
Fink,JeffreyC
中科院分区：
文献类型：
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作者：
Jones-Burton,Charlotte;Seliger,StephenL;Brown,Jeanine;Stackiewicz,Lucy;Hsu,VanDoren;Fink,JeffreyC
背景：在已知的慢性肾脏病（CKD）的危险因素中，种族是一个不可改变的因素，而吸烟是另一个可以改变的因素。此外，吸烟倾向于增加红细胞质量，这在CKD中经常减少。没有研究探讨吸烟对CKD患者贫血管理的相互作用的种族与方法。我们研究了吸烟对CKD患者贫血管理的影响及其在以前进行的研究中的CKD患者（n= 1312）开始每周epoprotein alfa和随后的16周的种族之间的变化。吸烟状态分为当前吸烟者与非吸烟者。种族分为非裔美国人和非裔美国人。估计肾小球滤过率的变化，尿白蛋白排泄，和红细胞生成反应每周epoadipine alfa进行了examined.Results.Overall，非洲裔美国人有较低的基线血红蛋白比非非洲裔美国人。非裔美国人非吸烟者在最终Hb（平均11.29 g/dl vs11.64 g/dl，P<0.001）或第16周Hb（平均11.61 g/dl vs11.86 g/dl，P= 0.02）方面与其他非吸烟者相比没有增加红细胞生成反应。然而，非裔美国人吸烟者比非吸烟者有更显著的红细胞生成反应，并且与吸烟的非裔美国人相当。有没有影响吸烟对肾功能或尿蛋白排泄的过程中的study.Conclusion。非裔美国人的非吸烟者表现出减少的反应，标准的epoxalfa剂量比其他种族的非吸烟者。然而，患有CKD的非裔美国吸烟者表现出与其他种族的患者相当的对epoadipalfa的反应。这些发现可能对患有CKD相关贫血的非洲裔美国人有影响。
Background.Of the known risk factors for chronic kidney disease (CKD), race represents one that is non-modifiable, while smoking is another that is modifiable. Moreover, smoking tends to increase red blood cell mass, which is frequently diminished in CKD. No studies have examined the interplay of race with smoking on anaemia management in patients with CKD.Methods.We examined the effects of smoking on anaemia management in CKD and its variation across race in a previously conducted study of CKD patients (n= 1312) initiated on weekly epoetin alfa and followed for 16 weeks. Smoking status was classified as currentvsnon-smoker. Race was classified as African-Americanvsnon–African-American. Changes in estimated glomerular filtration rate, urinary albumin excretion, and erythropoietic response to weekly epoetin alfa were examined.Results.Overall, African-Americans had lower baseline Hb than non–African-Americans. African-American non-smokers did not mount an erythropoetic response comparable to other non-smokers by final Hb (mean 11.29 g/dlvs11.64 g/dl,P<0.001) or week 16 Hb (mean 11.61 g/dlvs11.86 g/dl,P= 0.02). However, African-American smokers had a more significant erythropoietic response than their non-smoking counterparts and were comparable to their smoking non-African-American counterparts. There was no effect of smoking on renal function or urinary protein excretion over the course of the study.Conclusion.African-American non-smokers exhibit a diminished response to standard epoetin alfa dosing than non-smokers in other races. However, African-American smokers with CKD exhibit a response to epoetin alfa comparable to patients of other races. These findings may have implications for African-Americans who have CKD-related anaemia.