engleski

Erythropoietin requirement in endemic nephropathy.

Endemic nephropathy(EN) is an inflammatory, slowly progressive chronic tubulointerstitial bilateral desease with an endemic occurrence in some rural environments of Croatia, Bosnia and Hercegovina, Serbia, Bulgaria and Romania. Its etiology remains unknown despite many investigations into a possible relationship with environment, heritage, and immune mechanisms. The pathohistological findings in Chinese herbal nephropathy, now known as aristolochic acid nephropathy, are the same as those observed in EN. There are many similarities in clinical findings as well: damage occurs in the proximal tubule and patients exhibit very severe anemia in contrast to patients with other kidney diseases in the same stage of kidney damage. As of December 31, 2004, the Croatian Registry for Renal Replacement Therapy (CRRRT) had 2641 patients on hemodialysis, 199 of whom had EN as the primary cause of their end-stage renal disease. Among the 199 EN patients, 86 died (between 1999 and 2004), 14 went to Bosnia and Hercegovina ; 99 are alive, of whom 83 are on hemodialysis, 11 were transplanted, and five are on CAPD. Dialysis centers caring for EN patients are located in: Slavonski Brod (EN patients constitute 31% of all patients), Vinkovci (26%), Sisak (6%), and Osijek(5%). Patients with EN have more severe anemia than do the other patients. In Slavonski Brod, EN patients on hemodialysis had an average hemoglobin level of 80.84 g/L while other patients on dialysis had an average hemoglobin of 91.88g/L. Approximately 96% of EN patients required rHuEPO, but only 64% of other dialysis patients needed rHuEPO. In April 2004, at the Center for Dialisis in Slavonski Brod, the average weekly dose of rHuEPO/erythropoietin was 4965 IU for EN patients and 3916 IU for other patients. Thus, the need for erythropoietin among EN patients is 21%higher than among others. In fact, EN patients need 62 IU of rHuEPO for g/Hb/L while other patients need 43 IU of rHuEPO/ g/Hb/L, pointing to a 44% greater need per g/Hb/L than is observed for other patients.

Endemic nephropathy; erythropoietin

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