Vitamin B6 Therapy Does Not Improve Hematocrit in Hemodialysis Patients Supplemented with Iron and Erythropoietin
Vitamin B6 Therapy Does Not Improve Hematocrit in Hemodialysis Patients Supplemented with Iron and Erythropoietin
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维生素 B6 疗法并不能改善补充铁和促红细胞生成素的血液透析患者的血细胞比容
作者：
J. Weissgarten;D. Modai;D. Oz;Z. C. Levy;M. Cohn;O. Marcus;V. Dishi;E. Galperin;Z. Averbukh
背景/目的：吡哆醇缺乏可能是血液透析患者对铁和促红细胞生成素（EPO）给药反应不佳的原因。方法：我们研究了36例长期血液透析患者，他们补充了铁和EPO，但红细胞压积未能提高到33%以上。患者被分为三个相等的组，并进行如下6个月的评估：A组-没有额外的治疗; B组-补充口服吡哆醇50 mg/天，C组口服吡哆醇100 mg/天。结果如下：在我们所有的患者中，红细胞吡哆醇水平最初在健康人群的参考范围内，并且在研究期间没有显著变化。同样，铁蛋白水平和铁饱和度值保持正常和恒定。所有三组的血红蛋白和/或红细胞压积水平几乎保持不变。结论：结果表明，在吡哆醇状态正常的血液透析患者中，尽管适当补充铁和EPO，但未能达到最佳红细胞压积水平，额外的吡哆醇治疗不会产生任何红细胞压积升高。
Background/Aim: Pyridoxine deficiency may be the cause of failure to respond appropriately to iron and erythropoietin (EPO) administration in hemodialysis patients. Method: We studied 36 patients on chronic hemodialysis amply supplemented with iron and EPO, who failed to raise hematocrit levels >33%. Patients were divided into three equal groups and evaluated for 6 months as follows: Group A – no additional therapy; group B – supplemented with oral pyridoxine 50 mg/day, and group C received 100 mg/day pyridoxine orally. Results: In all our patients, erythrocyte pyridoxine levels were initially within reference range for a healthy population and did not vary significantly during the study period. Likewise, ferritin levels and iron saturation values remained normal and constant. Hemoglobin and/or hematocrit levels remained practically unchanged in all three groups. Conclusions: The results indicate that in hemodialysis patients with normal pyridoxine status who, despite appropriate supplementation of iron and EPO, fail to reach optimal hematocrit levels, additional pyridoxine treatment does not produce any hematocrit elevation.