[慢性肾病引起的贫血]。

Q4 Medicine
Acta Medica Croatica Pub Date : 2016-12-01
L Bukmir, M Fišić, I Diminić-Lisica, A Ljubotina
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引用次数: 0

摘要

肾性贫血继发于慢性肾脏疾病(CKD),其发病率随着CKD的进展而增加。其目的是根据国家指导方针,向家庭医生通报最新的发展情况和处理这一问题的方法。检索PubMed和Cochrane系统评价数据库,检索1996-2015年期间的以下关键词:贫血、慢性肾功能衰竭、促红细胞生成素和初级卫生保健。此外,人工检索了所有相关的文章和教科书,得出以下结论。使用促红细胞生成剂(ESA)可以减缓CKD的进展,减少输血需求,提高患者的生活质量。目标血红蛋白(Hb)浓度永久维持在110-120 g/L。较高的Hb水平与透析患者较高的死亡率和主要心血管事件相关。目标血红蛋白水平应根据CKD分期(非透析和透析人群)、年龄、其他风险、初始和维持治疗严格个体化。早期识别和适当纠正贫血的ESA对ckd患者是至关重要的。系统的一级和二级预防措施,以及家庭医生在日常工作中对国家指南的教育和专业执行,可以改善CKD患者的医疗护理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[ANEMIA IN CHRONIC KIDNEY DISEASE].

Renal anemia develops secondary to chronic kidney disease (CKD) and its incidence increases with the progression of CKD. The aim is to inform family physicians about the latest developments and ways of approaching the issue, in accordance with national guidelines. The PubMed and Cochrane systematic reviews databases were searched for the 1996-2015 period using the following key words: anemia, chronic renal failure, erythropoietin, and primary health care. In addition, all relevant articles and textbooks available were manually searched to suggest the following conclusions. The use of erythropoiesis-stimulating agents (ESA) slows down the progression of CKD, reduces the need for blood transfusions and improves the patient quality of life. Target hemoglobin (Hb) concentration to be permanently maintained is 110-120 g/L. Higher Hb levels are associated with higher mortality and major cardiovascular events in dialysis patients. Target hemoglobin level should be strictly individualized depending on CKD stage (both non-dialyzed and dialyzed population), age, other risks, initial and maintenance treatment. Early recognition and appropriate correction of anemia using ESA is of utmost importance in CKD patients. Systematic primary and secondary prevention measures along with education and professional implementation of national guidelines in daily work of family practitioners can improve medical care of patients with CKD.

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来源期刊
Acta Medica Croatica
Acta Medica Croatica Medicine-Medicine (all)
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期刊介绍: ACTA MEDICA CROATICA publishes original contributions to medical sciences, that have not been previously published. All manuscripts should be written in English.
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