1. Erythropoietin and hemodialysis (anemia) M106 65 陳嬿雅 104 陳佩儀

2. Erythropoietin(EPO) A glycoprotein - a hematopoietic growth factor of red blood cells (erythrocytes) in mammals A cytokine for erythrocyte precursors (hematopoietin or hemopoietin) - produced in the kidney and liver

3. Functional EPO Also : playing a significant role in the brain's response to neuronal injury involvement in the process of wound healing

4. Erythropoietin receptor (EpoR)  a hematopoietic cytokine receptor specifically present on erythroid progenitor cells Tyrosine kinase receptor

5. Recombinant human EPO a genetic engineering product identical to natural human The first clinical use for anemia(FDA)  chronic renal failure in predialysis or dialysis patients  zidovudine (Retrovir) therapy in patients infected HIV  patients receiving chemotherapy in nonmyeloid malignancies

6. Hemodialysis removing waste products from the blood renal replacement therapies Hemodialysis can be an outpatient or inpatient therapy Procedure

7. Hemodialysis Principle – Diffusion – Convection Classification – Intermittent dialysis – Continue dialysis Functions of hemodialysis

8. Indications & Complications Indications – Acute & chronic renal failure – Drug poisoning – Refractory edema – Metabolic Disturbances Complications – Low blood pressure – Fatigue – Nausea – Iron-deficiency Anemia : blood loss from the technique of hemodialysis

9. Anemia Having less than the normal number of RBC or less than the quantity of hemoglobin. – Male< 13.0g/dl – Female< 12.0g/dl Anemia in hemodialysical patient – Insufficiency or resistance of EPO – Blood loss – Insufficiency of iron, vit. C, Vit B6, Vit. B12 and folic acid

10. Treatments An adequate hemodialysis dose Monitoring the portion of blood iron regularly and its transfer efficiency Adequate complements of EPOs Appropriate nutrition intakes Doing some aerobic exercises (ex: swimming) Avoiding from blood loss Controlling infections in advance

11. References http://www.cari.org.au/CKD_Prevent_List_Published/Erythropoie tin.pdf http://www.cari.org.au/CKD_Prevent_List_Published/Erythropoie tin.pdf http://www.hdcn.com/symp/05anna/02/pet1/pet1.htm http://www.uptodate.com/contents/erythropoietin-for-the- anemia-of-chronic-kidney-disease-in-hemodialysis- patients?source=see_link http://www.uptodate.com/contents/erythropoietin-for-the- anemia-of-chronic-kidney-disease-in-hemodialysis- patients?source=see_link http://www.mountnittany.org/wellness- library/healthsheets/documents?ID=3890 http://www.mountnittany.org/wellness- library/healthsheets/documents?ID=3890 http://pubs.acs.org/cen/coverstory/83/8325/8325erythropoietin.html http://pubs.acs.org/cen/coverstory/83/8325/8325erythropoietin.html http://en.wikipedia.org/wiki/Hemodialysis http://www.epogen.com/professional/erythrokinetics/erythrokin etics.html http://www.epogen.com/professional/erythrokinetics/erythrokin etics.html http://www.nature.com/nrc/journal/v5/n7/fig_tab/nrc1648_F2.h tml http://www.nature.com/nrc/journal/v5/n7/fig_tab/nrc1648_F2.h tml http://www.cancernetwork.com/cancer-management- 11/chapter40/article/10165/1406535 http://www.cancernetwork.com/cancer-management- 11/chapter40/article/10165/1406535