Korean Journal of Nephrology 1997;16(3):501-508.

인 유전자 재조합 에르트로포에틴 ( 이프렉스 프리필드 시린지 ) 투여가 말기신부전 환자의 운동 능력과 삶의 질에 미치는 영향

최의진 , 송호철 , 진동찬 , 장윤식 , 윤성노 , 김석영 , 윤선애 , 안석주 , 이승헌 , 신영신 , 박철휘 , 김영옥 , 양철우 , 김용수 , 방병기

Abstract

To determine whether rHuEPO improves the exercise capacity and the global quality of life, 52 nondiabetic patients with end stage renal disease undergoing dialysis (hemodialysis 42, CAPD 10, M 34, F 18) were selected from 7 affiliated hospitals with the Catholic University in Korea. We injected rHuEPO (4000 unit 3 times a week, Eprex prefilled syringe. Cilag AG, Switzerland) subcutaneous to the patients with Hb level 7-9g/dL. After reaching the target Hb level 10-12g/dL, patients were maintained for another 4 weeks. All patients received oral or intravenous iron through trial. The exercise capacity was evaluated by using a standard incremental cycle exercise protocol with treadmill, step walk load in fixed floors and the global quality of life was assessed by means of an interview based on questionnaire (scale 1-7). The initial Hb level (7.4± 0.9g/dL) were increased to the target Hb level (10.0-12.0g/dL) on 5.5±2.3 week and highest level (11.8± 1.4g/dL) on 8 week (p<0.001). In exercise capacity test, the times of step walk in established two floors before rHuEPO, on target Hb, and after 4 weeks of target level were decreased (Group A: 2 floors, n=37, 15.3±5.0 sec, 14.5±4.4 sec, 13.9±4.7 sec, p<0.01, Group B: 3 floors, n=l3, 44.0±11.3 sec, 32.8±8.0 sec, 32.8±5.2 sec, p<0.01). The times of walk and the amounts of work load in treadmill before rHuEPO and after 4 weeks of target level were increased (walk time 482± 143 sec, 572±147 sec, p<0.01, work load 9.4±2.5 mets, 11.0±2.5 mets. P<0.01). In the global quality of life, all the score of improvement of fatigue (4.3 ±1.1, 5.2±1.0, 5.4±1.0), the daily activity (4.8±1.4, 5.5 ±0.9, 5.5± 1.1) and the quality of life (4.0±1.1, 4.8 ±0.7, 4.9±0.8) were improved (p<0.01). rHuEPO treated patients had increased blood pressure (before rHuEPO 138.8±21.7/82.3±10.5mmHg, after 4 weeks of target level 149.7±23.0/89.5±13.8mmHg, p<0.01) In conclusion, it is meaningful to maintain the Hb level of 10-12g/dL for better quality of life and exercise capacity in patients with end stage renal disease undergoing dialysis.