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CORRECTION OF RENAL ANAEMIA USING RECOMBINANT HUMAN ERYTHROPOIETIN (rHuEPO) IN PATIENTS ON HEMODIALYSIS
Pored Laboratorije za biohemiju Doma zdravlja u projektu su učestvovali Centar za bubrežne bolesti i Laboratorija za biohemiju univerzitetskog medicinski centra Zvezdara. Naš tim je na kongresu izazvao veliku pažnju svoj radom a ujedno imao priliku da se upozna sa najnovijim tehnikama koje se koriste u svetu u oblasti biohemiske analize.
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CORRECTION OF RENAL ANAEMIA USING RECOMBINANT HUMAN ERYTHROPOIETIN (rHuEPO) IN PATIENTS ON HEMODIALYSIS
G. Spasic Obradovic1, N. Dimkovic2 and V. Milatovic3.
1Laboratory of Biochemistry, Zvezdara University Medical Center, Belgrade, Serbia, 2Center for Renal Diseases, Zvezdara University Medical Center, Belgrade, Serbia, 3Laboratory of Biochemistry, Primary Care Clinic “Savski venac” , Belgrade,
Background. Reduced erythropoietin synthesis is one of the commonest complication in patients with chronic renal failure. Secondary anaemia due to reduced synthesis of erythropoietin leading to increased morbidity and mortality. Therefore, recombinant human erythropoietin (rHuEPO) is used for the treatment of renal anaemia, accompanied by i.v. supplementation of iron (Fe).
Methods. 40 patients undergoing regular treatment by repeated haemodialysis, diagnosed with renal anaemia, were included in the correction of anaemia.
Between February 2005 and October 2006, patients were treated by intravenous administration of rHuEPO in doses of 50-150 IU/kgBW, until the targeted value of 11-13 g/dl was achieved. In all patients, concurrent intravenous administration of Fe was applied aimed at maintaining optimal iron stores (ferritin>100?mol/l, Tsat>20%). Fe,UIBC,transferrin saturation and ferritin were determined using OLYMPUS AU400, while erythrocytes,Hg,Hct and reticulocytes were analysed using the ADVIA120. All analyses used original reagens.
Results. Biochemical and haematologic parameters at four points in time were as following: (Fe,Saturation,Ferritin,Hb)
Before the treatment: 8.20±2.6µmol/l; 0.18±0.036; 136±13.3µmol/l; 8.1±0.8g/dl
After 6 months: 10.40±2.9; 0.28±0.040; 420±76.66; 10.0±0.73
After 12 months: 11.20±3.1; 0.26±0.046; 360±74.66; 13.1±0.86
After 18 months: 10.80±2.2; 0.22±0.026; 298±63.33; 13.4±0.93
All of the observed parameters have showed values within the target ranges which confirm the positive outcome of the treatment. These levels were maintained even 18 months after the initiation of rHuEPO therapy.
Conclusions. A good correction of renal anaemia requires a replenishement of Fe reserves, an adequate dose of rHuEPO as well as regular monitoring of all parameters, especially during the correction phase.
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