血液透析患者肾性贫血治疗药物的研究进展

Research Progress of Therapeutic Drugs for Renal Anemia in Hemodialysis Patients

肾性贫血是慢性肾脏病的常见临床表现和重要合并症,治疗肾性贫血是慢性肾脏病一体化治疗的重要组成部分。引起肾性贫血的因素复杂,治疗肾性贫血的方法包括输血、使用红细胞生成刺激剂(ESA)、补充维生素、铁剂、叶酸、中药等。目前ESA已成为治疗血液透析患者肾性贫血最主要的药物,包括短效和长效促红细胞生成素(EPO)类蛋白质药物和低氧诱导因子脯氨酰羟化酶抑制剂口服小分子药物。为了提高EPO响应和疗效,临床上常补充铁剂、左卡尼汀、维生素、抗氧化剂和中药补血剂等。

Renal anemia is a common clinical manifestation and complication of chronic kidney disease.Thus,treatment of renal anemia is an important part of integrative therapy for chronic kidney disease.The factors leading to renal anemia are complex.Treatments of renal anemia include blood transfusion,use of erythropoiesis-stimulating agents(ESA),supplement of vitamin,iron,folic acid,and traditional Chinese medicine.At present,ESA has become the most important drugs for the treatment of renal anemia in hemodialysis patients.There are two types of ESA:short-acting and long-acting erythropoietin(EPO)and oral small molecule drugs:hypoxia inducible factor prolyl hydroxylase inhibitor.To improve EPO response and efficacy,iron,L-carnitine,vitamins,antioxidants and Chinese herbal blood-supplementing formula are usually adopted in clinical practice.