Darpeboetin治疗慢性肾脏疾病可以改善肾功能:可能的临床相关性

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摘要

背景:促红细胞生成素(EPO)作为第一个被发现的造血因子,已被临床用于治疗贫血。促红细胞生成素主要由肾脏(肾皮质成纤维细胞)产生,诱导红细胞祖细胞的增殖和分化。以往的研究表明,促红细胞生成素可能是由于肾小管上皮细胞、系膜细胞和内皮细胞上存在促红细胞生成素受体而直接刺激受损小管细胞的再生。EPO通过改善足细胞损伤直接预防肾小球硬化。因此,为了改善慢性肾脏疾病(CKD)患者的肾功能,临床研究EPO在CKD患者中的有益肾保护作用至关重要。方法:该研究在阿卜杜勒阿齐兹国王医疗城进行,纳入了患有慢性肾脏疾病的患者。患者首次接受Darpeboetin治疗。达泊博汀给药频率为每周单次。从医院电子病历系统(BestCareR)采集肾功能检查结果,包括血清肌酐、血清尿素、碱性磷酸酶、血清钙、血清磷、血清白蛋白和蛋白尿。治疗前后各项指标比较。在开始治疗前和治疗结束时。开始治疗前一周视为第0周(基线)结果:结果表明,每周单剂量达泊博汀治疗可降低血尿素氮(BUN p=0.002)和血清尿酸水平(p=0.009)。治疗对血清钙和钾的影响显示血清钾(P<0.001)、血清钙(P<0.001)和校正钙(P<0.001)水平显著升高,血清磷显著降低(p=0.004)。此外,慢性肾病患者的治疗显著改善了血清白蛋白(P<0.001)。结论:达泊博汀治疗可证实其肾保护作用。Darpeboetin是一种有希望预防或减轻组织肾损害的药物,特别是在慢性肾脏疾病中
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Treatment of Chronic Kidney Diseases with Darpeboetin can Ameliorate Kidney Functions: A Possible Clinical Relevance
Background: Erythropoietin (EPO) has been used clinically for the treatment of anemia as it was the first characterized hematopoietic factor. Erythropoietin is produced primarily by the kidneys (renal cortical fibroblasts) which induces proliferation and differentiation of erythroid progenitor cells. Previous studies suggested that erythropoietin may directly stimulates the regeneration of damaged tubular cells due to presence of erythropoietin receptors on renal tubular epithelial, mesangial and endothelial cells. EPO directly prevent glomerulosclerosis as a consequence of amelioration of podocyte injury. Therefore, to improve kidney function in chronic kidney disease (CKD), it is of critical importance to investigate clinically the beneficial reno-protective effects of EPO in patients with CKD. Methodology: The study was conducted at King Abdulaziz Medical City and included patients with chronic kidney diseases. Patients were under medical treatment with Darpeboetin for the first time. The administration frequency of Darpeboetin was single dose weekly. Kidney function tests including serum creatinine, serum urea, alkaline phosphatase, serum calcium, serum phosphorus, serum albumin and albuminuria were collected from the hospital electronic medical record system (BestCareR). Test values before and after treatment were compared. of the patients before starting treatment and at the end of treatment. The week before starting treatment was considered week 0 (baseline) Results: The results indicated that, treatment with a weekly single dose of Darpeboetin reduces blood urea nitrogen (BUN p=0.002) and serum uric acid level (p=0.009). The effect of treatment on serum calcium and potassium, showed a significant elevation of serum potassium (P<0.001), serum calcium (P<0.001) and adjusted calcium (P<0.001) levels parallel with significant decrease in serum phosphorus (p=0.004). Also treatment of chronic kidney disease patients significantly ameliorates serum albumin (P<0.001). Conclusion: Treatment with Darpeboetin may confirm the reno-protective potency. Darpeboetin is a promising drug to prevent or attenuate tissues kidney damage especially in chronic kidney disease
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