ダルベポエチン投与により貧血の改善を認めた骨髄異形成症候群合併糖尿病性腎症の1例

森田 さやか; 入村 泉; 江口 圭; 山下 真平; 吉田 宣子; 豊永 愛子; 竹村 俊輔; 髙木 通乃; 吉田 直史; 大屋 純子; 花井 豪; 田中 伸枝; 吉永 健太郎; 山田 典弘; 馬場園 哲也; 秋葉 隆; 泉二 登志子; 萩原 誠久; 渕之上 昌平; 内潟 安子

doi:10.4009/jsdt.48.365

High-dose darbepoetin therapy in a diabetic kidney disease patient with myelodysplastic syndrome

Sayaka Morita, Izumi Nyumura, Kei Eguchi, Shinpei Yamashita, Noriko Yoshida, Aiko Toyonaga, Shunsuke Takemura, Michino Takagi, Naoshi Yoshida, Junko Oya, Ko Hanai, Nobue Tanaka, Kentaro Yoshinaga, Norihiro Yamada, Tetsuya Babazono, Takashi Akiba, Toshiko Motoji, Nobuhisa Hagiwara, Shohei Fuchinoue, Yasuko Uchigata

Author information

Sayaka Morita
Department of Medicine, Diabetes Center
Department of Surgery, Kidney Center
Izumi Nyumura
Department of Medicine, Diabetes Center
Kei Eguchi
Department of Medicine, Diabetes Center
Shinpei Yamashita
Department of Medicine, Diabetes Center
Noriko Yoshida
Department of Medicine, Diabetes Center
Aiko Toyonaga
Department of Medicine, Diabetes Center
Shunsuke Takemura
Department of Medicine, Diabetes Center
Michino Takagi
Department of Medicine, Diabetes Center
Naoshi Yoshida
Department of Medicine, Diabetes Center
Junko Oya
Department of Medicine, Diabetes Center
Ko Hanai
Department of Medicine, Diabetes Center
Nobue Tanaka
Department of Medicine, Diabetes Center
Kentaro Yoshinaga
Department of Hematology
Norihiro Yamada
Department of Cardiology
Tetsuya Babazono
Department of Medicine, Diabetes Center
Takashi Akiba
Department of Blood Purification, Kidney Center, Tokyo Women’s Medical University School of Medicine
Toshiko Motoji
Department of Hematology
Nobuhisa Hagiwara
Department of Cardiology
Shohei Fuchinoue
Department of Surgery, Kidney Center
Yasuko Uchigata
Department of Medicine, Diabetes Center

Keywords: myelodysplastic syndrome, diabetic nephropathy, darbepoetin

JOURNAL FREE ACCESS

2015 Volume 48 Issue 6 Pages 365-370

DOI https://doi.org/10.4009/jsdt.48.365

Details

Abstract

We report a diabetic kidney disease patient with myelodysplastic syndrome (MDS) who was treated with high-dose darbepoetin-alfa and whose anemia improved, making it possible to decrease the use of red blood cell transfusion. He was diagnosed with diabetic kidney disease and MDS at the age of 74 years. He continued to have severe anemia despite continuous treatment with an erythropoiesis-stimulating agent (ESA) and transfusions as an outpatient. He was admitted to our hospital for severe anemia and over-hydration at 76 years of age. On admission, his hemoglobin was 6.8 g/dL and he experienced frequent angina attacks. After initiating dialysis, the dosage of darbepoetin-alfa was increased gradually to 180 μg administered intravenously weekly. As a result, his hemoglobin concentration was sustained at 8.0～9.0 g/dL, the frequency of transfusion could be reduced, and the angina attacks disappeared. However, his serum ferritin level increased and we attempted treatment with an oral iron-chelating agent, but severe nausea developed. High-dose ESA might be effective for MDS patients with CKD.

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