A patient of chronic renal failure maintained on intermittent haemodialysis has anaemia not responding to iron therapy. Which of the following additional drug is indicated
ERYTHROPOIETIN Erythropoietin (EPO) is a sialoglycoprotein hormone (MW 34000) produced by peritubular cells of the kidney that is essential for normal erythropoiesis. Anaemia and hypoxia are sensed by kidney cells and induce rapid secretion of EPO - acts on erythroid marrow and: (a) Stimulates proliferation of colony forming cells of the erythroid series. (b) Induces haemoglobin formation and erythroblast maturation. (c) Releases reticulocytes in the circulation. The recombinant human erythropoietin (Epoetin a, b) is administered by i.v. or s.c. injection and has a plasma t 1/2 of 6-10 hr, but action lasts several days. Uses:- The primary indication for epoetin is anaemia of chronic renal failure which is due to low levels of EPO. Only smptomatic patients with Hb <= 8 g/dl should be considered for EPO therapy. 2) Anaemia in AIDS patients treated with zidovudine. 3) Cancer chemotherapy induced anaemia. 4) Preoperative increased blood production for autologous transfusion during surgery. Ref:- kd tripathi; pg num:-611
Cyanocobalamin
Folic acid
Pyridoxine
Erythropoietin
Hematology