Transcription of 慢性腎臓病（CKD）における 貧血の初期評価
1 CKD Clinical Question 2015 8 3 J Hospitalist Network 65 5 1 50 1 2 1 2 ROS 2/19 BP:138/78mmHg,HR:65 /min ,RR:12 /minBT C, O2 Sat 97% JVD 3/19 WBC6,500/ g/dlHt26 %MCV 88 flPLT / lBUN 33 mg/dl mg/dl e-GFR 24 ml/ m2 HbA1c XP 4/19 Clinicalquestion CKD 5/19 CKD CKD 2013 G e-GFR24mL/ m26/19 Hb g/dl 15 6 5 5 12 12 15 16 World Health Organization. Worldwide Prevalence of Anaemia1993-2005:WHO Global Database on Anaemia.
2 In:deBenoistB, et al. 20087/19 CKD GFR Hb GFR 60 ml/ m2 CKD G3a G5 ArchInternMed2002;162:1401-1408 1988 1994 15,419 GFR Hb 95 5 95 GFR 60 Hb 8/19 GFR 60 ml/ m2 CKD G3a G5 Kidney International Supplements (2012) 2 CKD G3a G3bG4 G5 G5 G5 CKD 9/19 CKD EPO EPO Hb EPO Hb EPO EPO EPO 95%CIAnemia and chronic renal failure, Medicine (2015)Article in EPO hepcidin 25 B12 Kidney International Supplements (2012) 2 11/19 Anemia and chronic renal failure, Medicine (2015)Article in WBC Hb RBC MCV PLT TIBC Transferrin Saturation TSAT TIBC 100 B12 Kidney International Supplements (2012) 2 12/19 EPO A.
3 EPO 1) 2012 KDIGO 2) CKD EPO EPO EPO 1) CKD 20122)KDIGO Clinical Practice Guideline for Anemia in Chronic Kidney Disease, 2012 CKD EPO 10/19 13/19 CKD CKD MCV 80 MCV 80 100 MCV 101 B12 CKD) zidovudine UpToDate14/19 WBC6,500/ lRBC 284 x 104/ g/dlHt26 %MCV 88 flPLT / l 14,200/ l mg/dl LDH 210 U/l 83ng/ml 45 g/dlTIBC 250 g/dlTSAT 18 % B WBC PLT B12 CKD G4 Q 15/19 CKD CKD CKD TSAT 20% 15 % 30 % KDIGO 100 ng/ml 15 20 ng/ml 500 ng/ml KDIGO TSAT 18 % 83ng/ml 20mm EMR 16/19 KDIGO.
4 Kidney Disease Improving Global Outcomes CKD 2012 Hb 10 g/dl erythropoiesisstimulating agent ESA Hb 10 12 g/dl 12 g/dl Hb 13 g/dl 1) 100 ng/ml TSAT 20 1) N EnglJ Med 2006;355:2085-98 g/dl 10 g/dl ESA darbepoetinalfa 17/19 ESA Hb g/dl Hb g/dl Hb g/dl ng/ml TSAT % 2008 10 HD 11 ND, PD 100 2010 11 HD 11 13 ND, PD 12 HD 13 ND,PD 2012 10 100 250 2010 12 12 KDIGO2012 10 ND 9 10 HD, PD 500 30 13 KDIGO : Kidney Disease Improving Global Outcomes, ND , HD: , PD: ESA: erythropoiesis stimulating agent, TSAT: Transferrin Saturation 18/19 Takehomemessage CKD CKD EPO ESA 19/19
