stiinte med 3 2011.indd - Academia de Ştiinţe a Moldovei

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causes of the end stage renal disease, but their prevalence
has decreased from 90% till 75% during the last decade.
Dialysis and Kidney Transplantation Center activities have
shown the continuous increase of the number of patients
on chronic dialysis as well as of the number of yearly
performed dialysis sessions with simultaneous patients’
mortality reduction and increased patients survival.
Резюме
Хронический гломерулонефрит, тубулоинтерстициальные
нефропатии и наследственные патологии
остаются основной причиной терминальной стадии
почечной болезни, но их распространенность снизилась
с 90% до 75% в течение последнего десятилетия.
Деятельность Центра Диализа и Трансплантации
Почки показало непрерывное увеличение количества
больных на хроническом диализе, ежегодных сессий
диализа, с одновременным снижением смертности пациентов
и увеличением выживаемости пациентов.
THE EFFECT OF Α-ERHYTHROPOIETIN
ADMINISTRATION
IN DIALYSED PATIENTS
_______________________________________
Adrian Tănase 1,2 , universitary professor, M.D.,
PhD., Head of the Urology and Operative
Nephrology Department, Head of the Dialysis
Center, Head Specialist in Dialysis of the
Ministry of Health, Petru Cepoida 1 , M.D.,
Ph.D., nephrologist
1 – Public Medical-Sanitary Institution Clinical
Republican Hospital;
2. The State University of Medicine and
Pharmacy „Nicolae Testemiţanu”
Introduction
Regular erythropoietin administration is an
important measure in the amelioration of the dialyzed
patients’ quality of life [1]. Several meta-analyses
demonstrated the positive effect of erythropoietinstimulating
agents on the longevity of dialyzed
population [2]. Considering the relatively high cost
of such treatment it is important to determine the
group of patients, who can benefit the most from
such treatment, providing the highest clinical effect/
expenditures ratio [3]. There is a number of different
causes of the dialyzed patients’ hyporesponsiveness
to erythropoietin administration [4], although,
„malnutrition-inflammation complex” is considered
among the most important ones [5]. There were
proposed a lot of markers, that correlate with this
Buletinul AŞM
syndrome’s severity, usually relatively costly, an
are not routinely used in clinical practice. From
practical and economical point of view it is much
more appropriate to use well known, cheaper and
routinely carried out in clinical practice markers of
inflammation such as erythrocyte sedimentation rate.
Objective of the study is the evaluation of clinical
and economical efficacy of erythropoietin and blood
transfusions in dialyzed population.
Material and methods
We have performed a evaluation of one month
α-erythropoietin (Repretine®) administration in
patients on chronic dialysis. There were studied the
effects of its administration in 52 patients versus 57
patients without administration of erythropoietin.
These 109 patients were selected out of 139 patients
on chronic dialysis treated in the Dialysis and
Transplantation Center from the Clinical Republican
Hospital at the beginning of 06.2011 applying the
following exclusion criteria: patient’s death during the
study period (1 patient), administration of both blood
transfusions and erythropoietin (2 patients), absence
of anemia (17 patients) and lack of corresponding
analysis or clear hemorrhagic events, that needed blood
transfusion (10 patients). Studied group included 66
(60,6%) male and 43 (39,4%) female patients with
mean age 45,89±1,24 years old and mean dialysis
duration 4,73±0,43 years. Only 51 out of 109 patients
(46,79%) have no hemotransfusions in the previous
5 months. At the beginning of treatment 48 (44,04%)
patients suffered from the 1st grade anemia, 49
(44,95%) patients suffered from the 2nd grade anemia
and 12 (11,01%) suffered from the 3rd grade anemia.
From etiological point of view among underlying
pathologies predominated chronic glomerulonephritis
– 48 (44,04%) patients, chronic pyelonephritis – 26
(23,85%) and hereditary pathologies – 19 (17,43%).
Chronic viral hepatitides were present in 51 patients.
All studied patients were classified in 5 groups:
1st group included the patients on α-erythropoietin
(Repretine®) treatment and with ESR ≤ 30 mm/hour –
26 (23,85%) cases; 2nd group comprised the patients
on α-erythropoietin (Repretine®) treatment and with
ESR > 30 mm/hour – 26 (23,85%) cases, 3rd group
included the patients without erythropoietin treatment
and ESR ≤ 30 mm/hour – 17 (15,6%) cases, 4th group
included 28 (25,69%) patients without erythropoietin
treatment and ESR > 30 mm/hour. The 5th group was
comprised from 12 (11,01%) patients that needed
blood transfusions during the studied period and
took no erythropoietin treatment. All the groups
had similar demography, underlining pathology and
dialysis characteristics. ESR = 30 mm/hour (by the
end of α-erythropoietin treatment period) was selected