What Are Erythropoietin Stimulating Agents?
Erythropoietin (EPO), also known as erythrocyte stimulating factor, erythropoietin, is a human-derived glycoprotein hormone that stimulates the production of red blood cells. Hypoxia can stimulate the production of erythropoietin. Recombinant human erythropoietin has been used clinically for the treatment of anemia associated with renal insufficiency, acquired immunodeficiency syndrome / AIDS itself, or anemia or malignant tumor associated with treatment. Anemia and rheumatism, including anemia.
- Chinese name
- Erythropoietin
- Foreign name
- EPO
- Produce
- Mainly produced by the kidneys and a small amount by the liver
- Indication
- Suitable for patients with chronic kidney failure and anemia
- Contraindications
- Allergic to erythropoietin and human albumin
- Adverse reactions
- Adverse reactions are well tolerated and safer to apply
Basic Information
Structure and function of erythropoietin
- Normal human body has a certain amount of erythropoietin, which is mainly produced by the kidney and a small amount is produced by the liver. According to the source, it can be divided into endogenous and exogenous erythropoietin. Natural erythropoietin molecules include a polypeptide portion and a sugar chain portion. Erythropoietin, which is present in plasma, consists of 165 amino acids. Different types of erythropoietin amino acid polypeptides are consistent, with a molecular weight of 18 235Da. They are connected by disulfide bonds to form four stable -helical structures, which is the spatial conformation necessary to maintain the biological activity of erythropoietin. Erythropoietin is a colony-stimulating factor. Its physiological function is mainly to bind to the surface receptors of red blood cell progenitor cells, to promote the differentiation of red blood stem cells in the bone marrow into red blood cells, the synthesis of hemoglobin from nucleated red blood cells and the intramedullary network Red blood cells and release of red blood cells.
Erythropoietin indications
- 1. For the treatment of anemia combined with renal insufficiency, anemia caused by acquired immunodeficiency syndrome / AIDS itself or treatment-induced anemia, anemia associated with malignant tumors, anemia caused by rheumatism, and rheumatoid arthritis and severe Chronic anemia in patients with parasitic disease, sickle cell anemia, etc.
2. For patients who repeatedly collect blood for elective surgery.
3. Used to prevent anemia.
4. It is suitable for patients with chronic renal failure accompanied by anemia, including patients with and without dialysis, to increase or maintain red blood cell levels and reduce blood transfusion. Erythropoietin can avoid dependence on blood transfusion, but cannot replace emergency blood transfusion.
5. Can also be used for anemia caused by zidovudine; used to improve anemia symptoms in patients with globin production anemia (thalassemia) or precocious anemia; can accelerate the recovery of hematopoietic function after bone marrow transplantation; can also be used Anemia caused by excessive aluminum load.
Erythropoietin contraindications
- Patients who are allergic to erythropoietin, human albumin or mammalian cell derivatives, patients with hypertension who are difficult to control during hemodialysis, patients with lead poisoning, etc. are prohibited for pregnant and lactating women.
Erythropoietin adverse reactions
- Generally, the adverse reactions are light, well tolerated, and safer to apply. May cause an increase in blood pressure and occasionally induce cerebrovascular accidents or seizures.
Erythropoietin considerations
- 1. Before the initial treatment, the iron storage of the patient should be increased, the transferrin saturation should be at least 20%, and the serum ferritin should be at least 100ng / ml. For patients undergoing elective surgery, preoperative use can promote auto-hematopoiesis.
2. Use with caution in patients with potential infection, deficiency of folic acid or vitamin B12, hidden blood loss, hemolytic disease, increased parathyroid function, porphyria, and pregnant women.