臨牀透析 Vol.33 No.8(2)


特集名 予後改善を目指した透析医療
題名 貧血の改善はこうすれば生命予後に良い結果をもたらす
発刊年月 2017年 07月
著者 山本 裕康 厚木市立病院内科
【 要旨 】 貧血は慢性腎臓病患者にしばしば認められる代表的な合併症の一つであるが,その原因は多様である.慢性腎臓病以外に原因が認められない場合,腎性貧血と診断する.腎性貧血の治療は,過不足のない体内鉄を維持しつつ,ESAの投与を行うことが重要である.ESAへの反応性に乏しい場合,予後不良の危険があり,ESAの増量に委ねるのではなく,その原因を検証し適切な対処を行うことが重要である.
Theme Manifold preferable strategies for better prognosis of the dialysis patients
Title Management of anemia for improving the prognosis in chronic kidney disease patients
Author Hiroyasu Yamamoto Department of Internal Medicine, Atsugi City Hospital
[ Summary ] Anemia is a representative complication in patients with chronic kidney disease. There are various causes of anemia. A diagnosis of renal anemia is made when chronic kidney disease (CKD) alone is the primary cause of anemia and there are no other diseases present which might cause anemia. ESA administration is useful for management of renal anemia. It is important to maintain adequate iron storage without deficiencies or overloading. Patients with ESA hyporesponsiveness are likely to have poor prognoses.
When initial or subsequent ESA hyporesponsiveness is observed, the causes of hyporesponsiveness should be identified as soon as possible rather than increasing ESA dosage to increase Hb levels.
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