NORMALIZATION OF HEMATOCRIT IN PATIENTS WITH CRF

该子项目是利用NIH/NCRR资助的中心赠款提供的资源的许多研究子项目之一。子项目和研究者（PI）可能从另一个NIH来源获得主要资金，因此可以在其他CRISP条目中表示。所列机构为中心，不一定是研究者所在机构。贫血是慢性肾功能衰竭的主要并发症。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校正到33- 36%之间的目标红细胞压积。儿童的正常红细胞压积水平为40- 44%。我们的假设是，通过增加所描述的r-HU EPO剂量，红细胞压积的正常化将改善认知功能。 6-19岁的慢性肾衰竭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，以及测量警惕性的连续性能测试。当患者的红细胞压积为30%或更低时，当患者的红细胞压积升高至33-36%时，以及当患者的红细胞压积升高至40- 44%时，将进行这些研究。每例患者将在各自的红细胞压积下保持稳定三个月，以建立红细胞压积的稳定。 作为常规医疗护理的一部分，将每月监测红细胞压积水平。还将在入组研究时获得铁水平，以消除铁缺乏作为贫血的促成因素。 为了消除测试熟悉度作为结果的一个因素，对照患者将是没有贫血的慢性肾衰竭患者，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.