LEČENJE ANEMIJE KOD BOLESNIKA SA BUBREŽNOM INSUFICIJENCIJOM U USLOVIMA PANDEMIJE VIRUSA COVID -19 – IZAZOVI DANAS
Sažetak
Kod bolesnika sa akutnim oštećenjem bubrega (AOB), kao i kod bolesnika na dijalizi ili sa hroničnim bolestima bubrega (HBB), koji su oboleli od nove zarazne bolesti SARS-CoV-2, primećena je visoka stopa teške anemije. Najteža anemija, kada je u pitanju virus COVID-19, javlja se kod osoba sa teškom sistemskom upalom, koja se može razviti tokom bolesti, koju ovaj virus izaziva. Nedavna istraživanja pokazala su to da su povišene koncentracije D-dimera povezane sa nižim hemoglobinom i većim serumskim feritinom. Kontroverzni aspekt terapije kod bolesnika sa bubrežnim oboljenjima i infekcijom izazvanom virusom COVID-19 primećen je u obe populacije (sa AOB ili HBB), a odnose se na primenu agenasa za stimulaciju eritropoeze (ESA) u lečenju anemije. Agensi za stimulaciju eritropoeze predstavljaju revoluciju u lečenju anemije kod bolesnika sa bubrežnim bolestima. Ali, interakcija upalnog/imunološkog sistema sa koagulacijom izuzetno je naglašena kod bolesnika sa infekcijom izazvanom virusom COVID-19. Postavljaju se pitanja kako lečiti anemiju kod bolesnika sa virusom COVID-19, da li su ESA potencijalno štetne ili korisne, šta nas ohrabruje da nastavimo lečenje anemije kod bolesnika sa virusom COVID-19 upotrebom ESA i koje su mogućnosti:smanjiti ili premašiti rizike, kao i to da li je ovaj terapijski pristup novi izazov u lečenju infekcije izazvane virusom COVID-19.
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