การศึกษาภาวะ Pure Red Cell Aplasia จากการใช้ยา Recombinant Human Erythropoietin Alfa ในผู้ป่วยไตวายเรื้อรังระยะสุดท้ายที่ได้รับการบำบัดทดแทนไตด้วยการฟอกเลือดผ่านเครื่องไตเทียม ในโรงพยาบาลสมเด็จพระพุทธเลิศหล้า

บทคัดย่อ

Background: Pure red cell aplasia is the rare but severe side effect in patient with end stage renal disease who using rHu-erythropoietin. The study of PRCA will help us to evaluate safety of using rHuerythropoietin.

Objective: To determine the safety from side effect of pure red cell aplasia in end stage renal disease hemodialysis patients who received rHu-erythropoietin alfa (EPIAO).

Material and Method: A retrospective descriptive study record from hemodialysis patients with end stage renal disease in Somdejphraputtalerdla hospital who received rHu-erythropoietin alfa (EPIAO) for treatment anemia. Period of this study was 2 years which followed up pure red cell aplasia in hemodialysis patients. If patients had unexplained loss of efficacy (LOE) or had non response hematocrit, the doctor would sent 10 ml of clotted blood to test anti-rHuEpo antibody by radioimmunoprecipitation (RIP) at laboratory hemodialysis unit of Chulalongkorn hospital.

Result: Twenty two volunteers 10 males (45.5%) and 12 females (54.5%) completed this study had average age 66.32 ± 11.25 (S.D.) years and had history about chronic kidney disease for 3.95 years under lying and other diseases i.e. diabetic 6.14 years, hypertension 6.68 years. Mean hematocrit at 0, 6, 12, 18 and 24 month was 32.77%, 32.73%, 31.68% 33.36% and 32.14% respectively. Serum ferritin at 0, 6, 12, 18 and 24 month was about 669.84 ng/mL, 661.05 ng/mL, 692.73 ng/mL, 727.51 ng/mL and 697.14 ng/mL respectively. Four volunteers had blood clotted sent to test anti-rHuEpo antibody but not found anti-EPO antibody was in all volunteers.

Conclusion: All hemodialysis patients who had anemia associated chronic renal failure which received rHu-erythropoietin alfa (EPIAO) 24 months continuously to improve their anemia had satisfied hematocrit level and had not report of pure red cell aplasia from received rHu- erythropoietin alfa (EPIAO).