NORMALIZATION OF HEMATOCRIT IN PATIENTS WITH CRF

这个子项目是利用由NIH/NCRR资助的中心拨款提供的资源的许多研究子项目之一。子项目和调查员(PI)可能从另一个NIH来源获得了主要资金，因此可能会出现在其他CRISE条目中。列出的机构是针对中心的，而不一定是针对调查员的机构。贫血是慢性肾(肾)衰竭的主要并发症。先前的研究表明，慢性肾功能衰竭儿童的贫血可能会导致学习成绩下降。这种贫血可以用重组人促红细胞生成素(r-Hu EPO)治疗。目前的标准将允许将贫血纠正到目标红细胞压积在33-36%之间。儿童正常的红细胞压积水平在40%-44%之间。我们的假设是，红细胞压积的正常化，通过增加所述的r-Hu EPO剂量，将改善认知功能。6-19岁患有慢性肾功能衰竭的贫血儿童患者将接受正式的认知功能研究。这些研究包括测试智力的韦氏智力评分，测试记忆力的数字广度，以及衡量警觉性的持续表现测试。这些研究将在患者的红细胞压积为30%或更低时进行，当患者的红细胞压积提高到33%-36%时，再进行一次，当其提高到40%-44%时进行。每个患者将在各自的血细胞中稳定三个月，以建立稳定的血细胞比容。作为常规医疗护理的一部分，每月将监测红细胞压积水平。铁水平也将在加入这项研究时获得，以消除铁缺乏作为贫血的一个因素。为了排除检测熟悉度作为结果中的一个因素，对照患者将慢性肾功能衰竭患者列为无贫血患者，因此患者不需要r-Hu EPO治疗。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Anemia is a major complication associated with chronic renal (kidney) failure. Prior studies have shown that anemia in children with chronic renal failure may cause decreased school performance. This anemia can be treated with recombinant human erythropoetin (r-HU EPO). Current standards will allow for the correction of anemia to a goal hematocrit of between 33-36%. Normal hematocrit levels for children range from 40-44%. Our hypothesis is that the normalization of hematocrit, by increasing the r-HU EPO dose described, will improve cognitive functioning. Anemic pediatric patients between the ages of 6-19 years with chronic renal failure will have formal cognitive functioning studies administered. These studies include a Wechsler intelligence score to test intelligence, Digit Span to test memory, and Continuous Performance Test to measure vigilance. These studies will be conducted when the patient has a hematocrit of 30% or less, when the patient's hematocrit has been raised to 33-36% and once again when it has been raised to 40-44%. Each patient will be kept stable at the respective hematocrits for three months in order to establish stabilization of the hematocrit. Hematocrit levels will be monitored on a monthly level as part of routine medical care. Iron levels will also be obtained upon enrollment into the study to eliminate iron deficiency as a contributor to the anemia. In order to eliminate test familiarity as a factor in the results, control patients will be patients with chronic renal failure without anemia, so the patients do not have the need for r-HU EPO therapy.