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| 소아의 만성 신부전성 빈혈에 대한 에리트로포이에틴 요법 |
| 하일수 , 박혜원 , 정해일 , 최용 |
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| Abstract |
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Nineteen anemic chidren (13 boys & 6 girls, mean age: 10±4 years) with chronic renal failure (CRF) were treated with recombinant human erythropoietin (rHuEPO) for more than six months. Fifteen of the children were on replacement therapy (10 on hemodialysis, 5 on CAPD), and four were managed conservatively. Initial response to rHuEPO related directly to weekly dosage; To raise patients hematocrit over 30%, dosage over 180 U/kg/wk took a month, 150 180 U/kg/week took two months, and below 150 U/kg/week took more than three months. To maintain hematocrit between 27% and 33%, 136±49U/kg/wk of rHuEPO was necessary, with significant individual variations (range: 55-250 U/kg/ wk). Regarding the effect of rHuEPO, we found no difference between intravenous and subcutaneous ad- ministration in both initial and maintenance treatment. Relative drug resistance was noted in four children, in whom myelofibrosis associated with hyperpar- athyroidism seemed to be the leading cause. Both the number of patients who needed transfusion, and the number of transfusions in each patient decreased significantly after rHuEPO therapy. During the treatment period, all children needed iron supplementation, 47% needed initiation or addition of antihypertensive medications. Thrombosis of the arteriovenous fistula developed in two children on hemodialysis. Changes in BUN, serum creatinine, potassium, and phosphorus were not significant. |
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