Pharmacokinetics and hematologic response to subcutaneous administration of recombinant human erythropoietin in children undergoing long-term peritoneal dialysis: A multicenter study

1993 ◽  
Vol 122 (2) ◽  
pp. 297-302 ◽  
Author(s):  
Giovanni Montini ◽  
Graziella Zacchello ◽  
Francesco Perfumo ◽  
Alberto Edefonti ◽  
Sergio Bassi ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Multicenter Study ◽  
Recombinant Human Erythropoietin ◽  
Subcutaneous Administration ◽  
Hematologic Response ◽  
Human Erythropoietin

Effects of Subcutaneous Recombinant Human Erythropoietin in Patients on Continuous Ambulatory Peritoneal Dialysis

1993 ◽  
Vol 13 (2_suppl) ◽  
pp. 538-540 ◽  
Author(s):  
Bruno Di Paolo ◽  
Alvaro Marini ◽  
Barbara Fiederling ◽  
Lorenzo Di Liberato ◽  
Patrizia Santarelli ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Recombinant Human Erythropoietin ◽  
Cerebral Oxygenation ◽  
Subcutaneous Administration ◽  
Well Being ◽  
Dramatic Improvement ◽  
Human Erythropoietin ◽  
Red Cell Indices ◽  
Main Components

The use of recombinant human erythropoietin (rHuEPO) has revolutionized the treatment of renelanemia, but the dose regimens, the optimal frequency, and the effects on other target organs like the central nervous systems (CNS) are still under discussion. We designed a prospective, ongoing study with 10 stable continuous ambulatory peritoneal dialysis (CAPO) patients (6 males, 4 females; mean age 64.4±7.8 years), with a pretreatment hemoglobin (Hb) <7.0 901. and requiring regular blood transfusions. Seven patients were treated with 4000 U rHuEPO once weekly (Eritrogen, Boehringer Mannhelm), 2 patients received 4000 U every 5 and 8 days, and the last one 4000 U every 10 days. The target hematocrit was 33% and Hb 10.0 g%. The CNS activity was recorded as visual (YEP), brainstem (BAER), and somatosensory (SEP)-evoked potentials. The mean Hb concentration Increased from 6.9± 1.2g% to 10.3± 1.6 g% (p<0.001) over 8 weaks. There were no significant changes In urea, creatinine, and potassium levels, and urine output. rHuEPO Induced a decrease In latency of P100 YEP, In the four main components of BAER, and In the P27–N35 Intertime of SEP. Parallel to the Improvement of red cell Indices, patients experienced a dramatic Improvement In well-being. The subcutaneous administration of a single vial of rHuEPO Is safe, convenient, and Inexpensive In CAPO. The role of rHuEPO treatment In Improving the electro-physiological brain function In uremic and anemic patients remains to be studied and may not necessarily be based on Improved cerebral oxygenation.

Recombinant human erythropoietin therapy in pediatric patients receiving long-term peritoneal dialysis

1991 ◽  
Vol 5 (6) ◽  
pp. 718-723 ◽  
Author(s):  
Bradley A. Warady ◽  
Richard J. Sabath ◽  
Christine A. Smith ◽  
Uri Alon ◽  
Stanley Hellerstein
Keyword(s):  
Peritoneal Dialysis ◽  
Recombinant Human Erythropoietin ◽  
Pediatric Patients ◽  
Human Erythropoietin

Effect of Subcutaneous Administration of Recombinant Human Erythropoietin on Plasma Protein C, Protein S, and Antithrombin III Levels in Patients on Continuous Ambulatory Peritoneal Dialysis

1992 ◽  
Vol 15 (5) ◽  
pp. 264-268 ◽  
Author(s):  
K.N Lai ◽  
J.A. Yin ◽  
P.K.T. Li ◽  
P.M.P. Yuen ◽  
S.F. Lui
Keyword(s):  
Peritoneal Dialysis ◽  
Recombinant Human Erythropoietin ◽  
Protein C ◽  
Antithrombin Iii ◽  
Subcutaneous Administration ◽  
Protein S ◽  
Normal Range ◽  
C Protein ◽  
Human Erythropoietin ◽  
Coagulation Inhibitors

The effect of subcutaneous administration of recombinant human erythropoietin (rHuEPO) on plasma natural coagulation inhibitors (protein C, protein S, and antithrombin III) was evaluated in 10 uremic patients on continuous ambulatory peritoneal dialysis (CAPD). These patients were commenced on a 16 week-course of twice weekly rHuEPO by the subcutaneous route. The hemoglobin increased significantly from 6.9 ± 1.3 g/dl to 9.6 ± 1.9 g/dl after subcutaneous rHuEPO treatment (p<0.01) at an average dose of 84 ± 9 U/kg body wt/week. With rHuEPO therapy, a significant increase in platelet counts was observed, albeit within the normal range. A significant increase in the prothrombin time was demonstrated at 6 weeks after treatment and increased activated partial thromboplastin time was observed at 6 weeks and 16 weeks after rHuEPO administration although these measurements still remained in normal range. CAPD patients have comparable or even higher plasma levels of natural coagulation inhibitors compared with healthy controls supporting our previous findings that patients on CAPD have normal plasma levels due to an effective compensatory production despite peritoneal losses of these proteins with CAPD. No change in either the immunological or the functional activity of these natural coagulation inhibitors was demonstrated with rHuEPO therapy and clinical thrombosis was not observed during and after rHuEPO therapy. We conclude that there is no laboratory evidence of increased risk of thrombogenesis due to reduction of natural coagulation inhibitors with rHuEPO therapy.

Intraperitoneal Administration of Recombinant Human Erythropoietin

1992 ◽  
Vol 12 (4) ◽  
pp. 378-383 ◽  
Author(s):  
Leon A.M. Frenken ◽  
Dirk G. Struijk ◽  
Peter J.W. Coppens ◽  
Roland G.W.L. Tiggeler ◽  
Raymond T. Krediet ◽  
...  
Keyword(s):  
Recombinant Human Erythropoietin ◽  
Intraperitoneal Administration ◽  
Subcutaneous Administration ◽  
Hemoglobin Concentration ◽  
Treated Group ◽  
Efficacy And Safety ◽  
University Hospitals ◽  
Safe Alternative ◽  
Human Erythropoietin ◽  
Dialysis Solution

Objective To determine the efficacy and safety of intraperitoneal administration of recombinant human erythropoietin (rHuEPO) in continuous ambulatory peritoneal dialysis (CAPD) patients compared to subcutaneous rHuEPO. Design Prospective analysis of an open, nonrandomized investigation. Setting Outpatient CAPD clinics in two university hospitals. Patients Nine adult CAPD patients receiving rHuEPO intraperitoneally and 8 patients receiving rHuEPO sub-cutaneously. Intervention One hundred units of rHuEPO per kilogram of body weight were administered three times a week for 8 weeks or until the target hematocrit of 35% was reached. Thereafter, dosages of rHuEPO were adjusted for response. Intraperitoneal rHuEPO was administered in 1 L of dialysis solution during the night. Measurements Efficacy was assessed by measuring the increase in hemoglobin. Tolerance was assessed by monitoring side effects. Results In the first 8 weeks of treatment hemoglobin concentration increased from 64.5±12.9 glL to 98.3±16.1 g/L (p<0.0005) in the intra peritoneally treated group. In the subcutaneously treated group hemoglobin increased significantlyfaster (p<0.05) from 72.5±4.8 g/L to 119.2±11.3 g/L (p<0.0005) in the same period. Antihypertensive medication had to be increased or instituted in most of the patients in both groups. The incidence of peritonitis in the intraperitoneally treated group was not increased when compared to the pretreatment incidence. Conclusions Subcutaneously administered rHuEPO is superior to intraperitoneally administered rHuEPO with regard to the required dosages. However, the results of this study show that intraperitoneal administration of rHuEPO might be a convenient and safe alternative when subcutaneous administration is undesirable.

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