DOPPS研究引发的思考-血红蛋白波动与透析患者死亡正相关

Considerations from the DOPPS study-hemoglobin fluctuation is positively correlated to mortality in dialysis patients

随着对肾性贫血管理的深入,不少文献报导"血红蛋白稳定对于肾性贫血治疗的重要性及临床获益",多个国外研究及数据显示血红蛋白不稳定与透析(与非透析)患者死亡率直接相关,同时可增加透析患者的并发症及住院风险等。其中,最引人注目的是DOPPS研究。本文从DOPPS研究结果出发,探讨透析患者,尤其是血液透析患者中血红蛋白波动情况及其影响因素,血红蛋白波动与透析患者生存、转归情况的关系,血红蛋白的目标制定及对今后临床实践的指导意义。

With the progresses of renal anemia administration, many researches recognize that hemoglobin stability is an important index for the treatment and prognosis of renal anemia. Evidences from other countries indicate that hemoglobin instability has a direct relationship with mortality in dialysis and non-dialysis patients. Among these studies, the DOPPS study is worthwhile to be concerned. Here we discuss hemoglobin fluctuation and its related factors, the relationship between hemoglobin fluctuation and patient’s survival and outcome, the ideal target of hemoglobin level, and its clinical significance in dialysis patients especially in hemodialysis patients.