<International Circulation>: For renal insufficiency patients with renal anaemia and renal hypertension but do not require haemodialysis; the use of erythropoietin may help alleviate the anaemia but may cause problems for blood pressure. Under these conditions what factors are important when we use erythropoietin?

  《国际循环》：对于患有肾性贫血和肾性高血压而尚不需要进行血液透析的肾衰患者来说，使用促红细胞生成素可以缓解贫血的症状，但可能引起血压升高。在上述情况下，促红细胞生成素的适应症是哪些？

    Prof Juliana Chan:  I think currently the use of erythropoietin (EPO) in patients with end stage renal disease is still quite controversial.  I think most guidelines will recommend the use of EPO in patients with a haemoglobin level up to 11g/dl but whether you can improve cardiovascular outcome is still very much debatable.  Certainly， I think anaemia is a very powerful predictor of outcome in our populations because in part anaemia means tissue hypoxia because haemoglobin carries oxygen; this amplifies morbidity and so I think increasing haemoglobin to around 11g/dl is probably acceptable. However， to fully normalize this I think we must strike a balance.

    Chan教授：我觉得目前给予肾衰终未期患者促红细胞生成素治疗仍存在争议。我想许多指南介绍过患者使用EPO后血红蛋白上升到11g/dl，但至于能否改善心血管疾病的预后尚无定论。我觉得贫血在我们人群的患者中是一个非常有效的预后检测指标，因为红细胞的功能是运输氧，贫血意味着组织缺氧，贫血会加重病情，因此我觉得将血红蛋白增加到11g/dl是可以接受的。但若要让EPO的使用标准化合仍需要多方权衡。