中国血液净化

中国血液净化 ›› 2017, Vol. 16 ›› Issue (08): 505-508.doi: 10.3969/j.issn.1671-4091.2017.08.001

• 专题与讲座 •    下一篇

炎症对慢性肾脏病贫血的影响

王磊1,左力1   

  1. 1. 北京大学人民医院肾内科
  • 收稿日期:2017-04-20 修回日期:2017-06-22 出版日期:2017-08-12 发布日期:2017-08-12
  • 通讯作者: 左力zuolimd@hotmail.com E-mail:ZuoLiMD@Hotmail.com

The effect of inflammation on the anemia in chronic kidney disease patients

Lei WANG,   

  • Received:2017-04-20 Revised:2017-06-22 Online:2017-08-12 Published:2017-08-12

PDF

503

摘要： 贫血是慢性肾脏病常见并发症，发生机制同时涉及了铁和红细胞生成素缺乏。现有证据表明，慢性肾脏病患者常存在免疫抑制和免疫系统的慢性激活状态，炎性细胞因子水平升高并阻碍红细胞生成，干扰铁稳态，使得慢性肾脏病贫血的发生和治疗复杂化，出现红细胞生成素治疗低反应性，盲目增加红细胞生成素和铁剂剂量除了增加药物相关副作用发生率外，还可能影响患者长期预后。充分理解炎症对慢性肾脏病贫血的影响，将有助于慢性肾脏病患者贫血的科学管理。

关键词: 贫血, 炎症, 炎症因子, 慢性肾脏病, 红细胞生成刺激剂

Abstract: Anemia is one of the common complications in chronic kidney disease (CKD) patients, mainly caused by iron and erythropoietin (EPO) deficiency. There are evidences that both inhibition and chronic activation of immune system are present in CKD patients. Higher inflammatory cytokine levels disturb iron metabolism
and erythropoiesis, resulting in anemia resistant to erythropoiesis stimulating agents (ESAs) and more hurdles in treatment of these patients. In this situation, increase of iron and EPO doses has negative effect on prognosis and produces more side effects of these medications. Understanding the effects of inflammation on anemia in CKD patients will help us appropriately manage anemia in these patients.

Key words: Anemia, Inflammation, Inflammatory cytokines, Chronic kidney disease, Erythropoiesis stimulating agent