risks of blood transfusion. Erythropoietin (EPO) is given S.C. 4000u three
times weekly, it carries the advantage of being safe and effective, but it is
very expensive. The dose of EPO has to be readjusted to maintain
haemoglobin value of 9-11 gm/dl.
d. Symptomatic treatment of:
- Hypertension is controlled by hypotensive drugs.
- Itching is treated by skin soothing creams, anti-histaminics,
treatment of hyperphosphataemia, hyper and hypocalcaemia. For
severe, intractable cases, parathyroidectomy may be of help. - G.I.T. manifestations as vomiting could be controlled by antacids
and H 2 -receptors blockers.
Failure of conservative treatment to provide the patient with a
reasonable quality of life is an indication for renal replacement therapy,
i.e. dialysis or renal transplantation.
Step 4. RENAL REPLACEMENT THERAPY (RRT):
This includes dialysis (haemodialysis and peritoneal dialysis) and
renal transplantation. Early induction of RRT and good nutritional
support provide better response to the treatment (less patient morbidity
and mortality).