Anaemia in dialysis patients as a side-effect of sartanes
Anaemia in dialysis patients as a side-effect of sartanes
复制标题
沙坦类药物的副作用导致透析患者贫血
DOI：
10.1016/s0140-6736(05)60259-0
复制
发表时间：
1998
期刊：
影响因子：
--
通讯作者：
U. Hällfritzsch
中科院分区：
文献类型：
--
作者：
A. Schwarzbeck;K. Wittenmeier;U. Hällfritzsch
自1996年以来，我们使用沙坦类药物代替血管紧张素转换酶抑制剂来控制血液透析患者的血压。起效平稳和无类过敏性膜反应是主要原因。由于我们在一些接受氯沙坦治疗的患者中发现了原因不明的血红蛋白降低和r-Hu Epo反应延迟，因此我们对Horn及其同事的病例报告很感兴趣。1我们回顾性研究了184例透析患者的数据，发现氯沙坦（50 mg/天）对血红蛋白浓度有显著影响。在24例接受氯沙坦治疗的血液透析患者中，18例血红蛋白下降。其中14人接受r-Hu Epo治疗，没有缺铁。平均血红蛋白浓度从118 g/L下降到101 g/L，4-6周后开始氯沙坦和恢复到112 g/L后，只有在r-Hu Epo剂量增加3倍至4倍。由于当时没有发现氯沙坦与贫血之间的联系，因此只有1名患者在6个月后因低血压而停药。停药导致血红蛋白从90 g/L升至135 g/L。在她停药后，开了几次氯沙坦
Since 1996, we have used sartanes instead of angiotensinconverting-enzyme inhibitors to control blood pressure in haemodialysis patients. The smooth onset of action and lack of anaphylactoid membrane reactions were the main reasons. Because we had seen unexplained decreases of haemoglobin and delayed r-Hu Epo responses at the start of haemodialysis in some patients on losartan, we were interested in the casereport of Horn and colleagues. 1 We investigated the data of 184 dialysis patients retrospectively and found that losartan (50 mg/day) had substantially affected haemoglobin concentrations. Of 24 haemodialysis patients on losartan, 18 had decreases in haemoglobin. 14 of these were on r-Hu Epo therapy and had no iron deficiency. Mean haemoglobin concentrations had fallen from 118 g/L to 101 g/L, 4–6 weeks after start of losartan and returned to 112 g/L only after a three-fold to four-fold rise in r-Hu Epo doses. Since no connection between losartan and anaemia has been made at that time, the drug was withdrawn in only one patient because of hypotension after 6 months. Withdrawal resulted in a rise of haemoglobin from 90 g/L to 135 g/L. Losartan was prescribed several times after withdrawal by her