| ObjectiveTo investigate the prevalence and treatment in maintenance of blood purification(MHD) patients with renal anemia and summarize the major cause of ill, in order to provide more effective basis in clinical.Method1958cases were collected from July to December2011, containing Zhengzhou, Luoyang, Xinxiang, Xinyang, Kaifeng, Nanyang, Pingdingshan seven cities,22blood purification centers which dialysis machines all≥5outpatient and hospital maintenance blood purification of patients, take the questionnaire to collect clinical data and laboratory data. According to the NKF-DOQI anemia diagnostic criteria in2006:men of hemoglobin(Hb)<135g/l, and women of Hb<120g/l; Cross-sectional survey the prevalence of patients with renal anemia, the related risk factors, anemia treatment and curative effect.ResultsMHD patients selected for the1958cases, the male1100cases, accounting for56.18%,female858cases, accounting for43.82%(the sex ratio of male to female was 128.21to100); Age from5to89years old, average age was (53.39■15.88) years;1958cases of MHD patients with anemia1532cases, prevalence of anemia was78.24%, male, female prevalence of anemia was66.55%and93.24%, mild, moderate, severe anemia prevalence were31.31%,39.61%,11.54%.269cases of patients with hemoglobin(Hb) has reached the target goal and the Hb compliance rate was17.54%. Different basis of anemia in patients with kidney disease in comparison:prevalence of anemia in descending order of diabetic nephropathy(74.65%), chronic glomerulonephritis(72%), high blood pressure kidney damage(71.23%), polycystic kidney disease (70.83%), primary nephrotic comprehensive levy (70%), urinary tract obstruction (66.67%),6groups of the prevalence of anemia was no significant difference (P=0.913).1532cases of MHD patients with anemia, EPO treatment of patients accounted for95.01%, not accounted for4.99%; the total dose of EPO average weekly use was (5249.55±2140.62) u; Different EPO use dose group comparison:age, dialysis age were no statistically different,<100U/(kg-w) group,100-150U/(kg-w) group and150~200U/(kg-w) group compared with using EPO, with the increase in EPO dose, Hb level tended to increase, and150to200U/(kg-w)group, the rate of iron treatment ratio, ferritin, TSAT compliance rate was significantly higher than the previous two groups (P＜0.05).1532cases of MHD patients with anemia, serum ferritin follow-up rate of68.79%compliance rate was73.42%, Transferrin saturation (TSAT) follow-up rate of57.19%, the compliance rate was72.46%.Comprehensive ferritin and TSAT two iron metabolism evaluation standard,34.99%of MHD patients with anemia have reached the iron metabolism targets,851MHD patients using the iron treatment, iron therapy was55.55%, which the use of intravenous iron treatment rate of21.16%, the use of oral iron therapy rate of45.69%,33.15%the use of intravenous and oral iron therapy. MHD patients with anemia of iron a different way to use between the intravenous iron group and the oral iron therapy group, the average ferritin, TSAT and average Hb was higher than the oral iron group (P＜0.001), but the intravenous iron group the EPO dose was lower than the oral iron therapy group (P＜0.001). ConclusionMost of MHD patients exist renal anemia, anemia prevalence as high as78.24%, and anemia treatment rate as high as94.13%,although the majority of patients receiving the treatment of anemia, but anemia treatment compliance rate as low as17.54%, mainly caused by:EPO therapeutic doses insufficiency, the iron agent especially intravenous iron deficiency use, regular hemodialysis deficiency and without the use of folic acid, vitamin B12and so on. |
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