肾性贫血治疗指南幻灯片.pptVIP

肾性贫血治疗指南 CPR 1.1. IDENTIFYING PATIENTS AND INITIATING EVALUATION 1.1.1 Stage and cause of CKD: In the opinion of the Work Group, Hb testing should be carried out in all patients with CKD, regardless of stage or cause. 1.1.2 Frequency of testing for anemia: In the opinion of the Work Group, Hb levels should be measured at least annually. 1.1.3 Diagnosis of anemia: In the opinion of the Work Group, diagnosis of anemia should be made and further evaluation should be undertaken at the following Hb concentrations: ● 13.5 g/dL in adult males. （12.0 g/dL ） ● 12.0 g/dL in adult females. （11.0 g/dL ） 贫血定义 WHO 的贫血诊断标准： 成人女性血红蛋白（Hb） 120 g/L 成人男性 Hb 130 g/L 但应考虑患者年龄、种族、居住地的海拔高度和生理需求对Hb 的影响。 CPR 1.2. EVALUATION OF ANEMIA IN CKD 1.2.1 In the opinion of the Work Group, initial assessment of anemia should include the following tests: 1.2.1.1 A complete blood count CBC including—in addition to the Hb concentration—red blood cell indices mean corpuscular hemoglobin [MCH], mean corpuscular volume [MCV], mean corpuscular hemoglobin concentration [MCHC] , white blood cell count, and differential and platelet count. 1.2.1.2 Absolute reticulocyte count. 1.2.1.3 Serum ferritin to assess iron stores. 1.2.1.4 Serum TSAT or content of Hb in reticulocytes CHr to assess adequacy of iron for erythropoiesis. 贫血实验室检查内容 血红蛋白/红细胞压积（Hb/Hct） 红细胞指标（红细胞计数、平均红细胞体积、平均红细胞血红蛋白量、平均红细胞血红蛋白浓度等） 网织红细胞计数（有条件提倡检测网织红细胞血红蛋白量） 铁参数（血清铁、总铁结合力、转铁蛋白饱和度、血清铁蛋白） 大便粪隐血试验。 CPG AND CPR 2.1. HB RANGE 2.1.1 Lower limit of Hb: In patients with CKD, Hb should be 11.0 g/dL or greater. MODERATELY STRONG RECOMMENDATION 2.1.2 Upper limit of Hb: In the opinion of the Work Group, there is insufficient evidence to recommend routinely maintaining Hb levels at 13.0 g/dL or greater in ESA-treated patients. 2.1 HEMOGLOBIN TARGET 2007 2.1.1 In the opinion of the Work Group, selection of the Hb target and selection of the Hb level at which ESA therapy is initiated in the individual patient should include consideration of po