FAKTORI KOJI DOPRINOSE BOLJEM OPORAVKU OD ANEMIJE OSOBAMA NA HEMODIJALIZI PRILIKOM PRIMENE REKOMBINANTNOG ERITROPOETINA
Sažetak
Uvod/cilj: Anemija se najčešće javlja kod bolesnika na hroničnom programu hemodijalize i uzrok je smanjenog kvaliteta života. Cilj studije je bio da identifikuje faktore koji doprinose osobama na hemodijalizi bolju kontrolu anemije primenom rekombinantnog eritropoetina.
Metode: Studijom preseka su 2017. godine, bile obuhvaćene 52 osobe na hemodijalizi iz Kliničkog centra Crne Gore. Ispitanicu su podeljini na one kod kojih je posle 3 meseca od primene rekombinantnog eritropoetina došlo do porasta hemoglobina na zadovoljavajuće vrednosti (110 g/l ili više) (grupa 1) i one kod kojih je vrednost hemoglobina i dalje bila niža od 110 g/l (grupa 2). Od svih ispitanika prikupljeni su podaci iz istorija bolesti. U statističkoj analizi podataka korišćen je t-test.
Rezultati: Posle tromesečne primene terapije eritropoetinom samo kod 21 bolesnika (40,4%) je postignuta ciljna vrednost hemoglobina od 110 g/l ili više (grupa 1), a kod 59,6% vrednosti hemoglobina su bile niže od 110 g/l. Ispitanici kod kojih nisu postignute ciljne vrednosti hemoglobina su primali značajno veće prosečne doze eritropoetina i imali veći indeks telesne mase nego ispitanici kod kojih su postignute ciljne vrednosti hemoglobina. Između ispitivanih grupa nije bilo značajne razlike u odnosu na odgovor na eritropoetin, dužinu trajanja terapije eritropoetinom, dužinu trajanja dijalize, starost ispitanika, debljinu kožnog nabora, obim nadlaktice, vrednosti transferina, broj eritrocit, vrednosti albumina, hemoglobina, hamatokrita i gvožđja.
Zaključak: Mogući faktori koji doprinose lošijoj kontroli anemije su više doze eritropoetina i veći stepen uhranjenosti procenjen prema indeksu telesne mase. Neophodna su dalja istraživanja u cilju pronalaženja faktora koji bi doprineli odklanjanju anemije kod osoba na hemodijalizi, jer nelečena anemija može dovesti do brojnih nepovoljnih ishoda (loš kvalitet života, kardiovaskularne bolesti, cerebrovaskularni insult, smanjenje opšte stope preživljavanja i drugo).
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