- 期刊
末期腎病變患者的促紅血球生成素阻抗：簡要回顧
Erythropoiesis-Stimulating Agent Resistance in End-Stage Renal Disease Patients: The Brief Review
摘要
促紅血球生成素（erythropoiesis-stimulating agent, ESA）目前被廣泛用來治療因慢性腎臟病而引發的貧血。ESA阻抗（ESA resistance）或反應不良（hyporesponsiveness）是指病患在即使使用了高劑量的ESA依然無法達到目標血紅素（target Hb）或是需要非常高劑量ESA才能維持目標血紅素。造成ESA阻抗的最常見的原因是鐵質缺乏、感染和慢性發炎，其他像是不足量透析、副甲狀腺功能亢進、高血壓藥物也有可能和ESA阻抗有關。這篇文章整理了常見造成ESA阻抗的原因和病生理機轉以及針對疾病的治療處置。
並列摘要
Erythropoiesis-stimulating agents (ESAs) are widely used to treat chronic kidney disease-related anemia. ESA resistance, is a term used to describe patients who do not achieve the target hemoglobin (Hb) concentration despite higher than usual doses of ESAs or who require increasingly higher ESA doses to maintain an Hb concentration. The most common causes of ESA resistance are iron deficiency, infection, and chronic inflammation. Other reasons such as inadequate dialysis, hyperparathyroidism, some antihypertensive agents, may also cause ESA resistance. This article summarizes the common causes and pathophysiology of ESA resistance and the proposed therapeutic interventions.
延伸閱讀
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