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| Renin - Angiotensin Axis가 만성신부전 환자의 빈혈에 미치는 영향 |
| 김동진 , 백석기 , 현정례 , 박훈기 , 이계영 , 윤성철 |
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| Abstract |
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Recently, there have been some reports on the activation of Renin Angiotensin Axis(R A axis)by Erythropoietin(EPO). Futhermore, the investigation on the EPO production induced by R A axis change have been reported. We observed the blockade of the R A axis with Angiotesin Converting Enzyme inhibi- tor(ANG CEI) prevent the rise in hemoglobin of chronic renal failure. In experimental studies, the activation of R A axis and anemia were induced by blood sampling from inferior vena cava of twenty- three Spague Dawley rats but sampled blood amount of fouteen rats was replaced by normal saline to prevent the activation of R A axis. The serum EPO lev- els were aignificantly decreased in the group of rats replaced by normal saline. In clinical studies, 30 patients were divided into two groups. Group A: 15 CRF patients undergoing hemodialysis received ANG -CEI(enalapril). Group B:15 CRF patients undergo- ing hemodialysis didn't receive ANG-CEI as an antithypertensive drug. The frequency of thrans- fusion per year wss significantly higher in group A as well as in patients with higher dose of ANG-CEI. In conclusion, we observed significantly more require- ment of transfusion in chronic renal failure patients under treatment of ANG CEI. Therefore, continuous administration of ANG CEI ean aggravste the ane- mia of chronic renal failure. |
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