紅血球生成刺激劑在慢性腎臟病貧血治療的角色

The Role of Erythropoiesis-Stimulating Agent in the Management of Anemia in Chronic Kidney Disease Patients

李文欽(Wen-Chin Lee) ； 田志宏(Chee-Hong Chan) ； 許莉美(Limei Hsu)

《腎臟與透析》 31卷4期 (2019/12) Pp. 171-174

https://doi.org/10.6340/KD.201912_31(4).0003

摘要

紅血球生成素主要由腎小管周圍的間質細胞製造，慢性腎臟病人發生貧血時，腎臟無法製造足夠紅血球生成素以刺激骨髓造血。紅血球生成刺激劑（erythropoiesis-stimulating agent, ESA）的臨床應用，改善了慢性腎臟病人的貧血，減少輸血的治療，也改善了其生活品質。ESA的使用途徑及劑量選擇，應依據病人疾病狀態、血色素現況值、血色素目標值等決定。其臨床使用可依據治療準則之建議，對於ESA反應不良的病人，則應積極找尋原因並矯正。

關鍵字

貧血 ； 慢性腎臟病 ； 血液透析 ； 紅血球生成刺激劑

並列摘要

Erythropoietin is generated mainly in peritubular interstitial cells of the kidney. In chronic kidney disease with anemia patients, the kidney could not generate enough erythropoietin to stimulate red blood cell produced in bone marrow. The clinical application of erythropoiesis-stimulating agents (ESAs) improve anemia, decrease the treatment of blood transfusion, and improve the quality of life in chronic kidney disease patients. The administration route and dosage of ESAs are determined by patient's disease status, the current hemoglobin level, and the target hemoglobin level. The clinical use of ESAs can follow the clinical guideline. In patients with hypo-response to ESAs, search for the etiology aggressively and correction are indicated.

並列關鍵字

anemia ； chronic kidney disease ； hemodialysis ； erythropoiesis-stimulating agent