处方腹腔透析:在腹腔透析中处方铁的模式
Sebastian Spencer1,2,3, Samantha Hunter3, Sunil Bhandari2,3
1Department of Medical Science, University of Hull, Hull, UK.
概括
英国临床医生为腹膜透析 (PD) 患者展示了各种铁疗法实践. 高剂量静脉注射 (IV) 铁是首选的,但对缺铁性贫血的最佳策略需要通过临床试验进行进一步的研究.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 血液学 血液学 血液学
- 临床药房 临床药房
背景情况:
- 在接受腹腔透析 (PD) 的患者中,缺铁和贫血很常见.
- 口服铁可能不足或耐受不佳,而静脉注射 (IV) 铁提供更好的耐受性和血红蛋白反应.
- 对PD患者的最佳静脉铁剂量,间隔和目标研究不足,导致实践变化.
研究的目的:
- 评估英国当前的临床实践,用于治疗PD患者的铁疗法.
- 为了估计患者的资格,未来随机对照试验 (RCT) 铁补充在PD.
主要方法:
- 英国科临床医生的横截面调查,使用9项电子问卷.
- 通过使用描述性统计数据和对量化数据和自由文本数据进行主题分析来分析答案.
主要成果:
- 来自23个单位的41名临床医生参与了这项研究;65.9%的人更喜欢高剂量的静脉注射铁 (≥500 mg/次).
- 开始铁疗法通常发生在血清费里<200μg/L或TSAT<20%的情况下.
- 先进的生物标志物很少使用;在活跃感染 (90.2%) 或过敏 (92.7%) 时,避免使用铁疗法.
结论:
- 英国对PD患者的铁疗法实践存在显著的差异.
- 高剂量的静脉注射铁是最受欢迎的,但诊断和安全问题仍然存在.
- 需要进一步的研究,包括一个强大的RCT,以建立最佳的铁补充策略,并改善PD的贫血管理.
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