scholarly journals Adequate administration of darbepoetin alfa improves renal anemia in Japanese peritoneal dialysis patients for whom the maximum dose of recombinant human erythropoietin did not fully achieve improved anemia

2012 ◽  
Vol 45 (3) ◽  
pp. 247-253
Author(s):  
Hideki Hiramatsu ◽  
Hiroki Hayashi ◽  
Masashi Mizuno ◽  
Yasuhiro Suzuki ◽  
Susumu Toda ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Darbepoetin Alfa ◽  
Recombinant Human Erythropoietin ◽  
Maximum Dose ◽  
Renal Anemia ◽  
Dialysis Patients ◽  
Human Erythropoietin

Subcutaneous Administration of Darbepoetin Alfa Effectively Maintains Hemoglobin Concentrations at Extended Dose Intervals in Peritoneal Dialysis Patients

2009 ◽  
Vol 29 (2) ◽  
pp. 199-203 ◽  
Author(s):  
Yu-Wei Fang ◽  
Chung-Hsin Chang
Keyword(s):  
Peritoneal Dialysis ◽  
Darbepoetin Alfa ◽  
Transferrin Saturation ◽  
Subcutaneous Administration ◽  
Renal Anemia ◽  
Dose Titration ◽  
Dialysis Patients ◽  
Evaluation Period ◽  
Reactive Protein ◽  
Human Erythropoietin

Objective Darbepoetin alfa is an erythropoietic-stimulating protein with a threefold longer half-life than recombinant human erythropoietin (rHuEPO) and can be used less frequently in the treatment of renal anemia. The purpose of this single-center single-arm study was to determine whether darbepoetin alfa, when administered at extended dose intervals, is as effective as rHuEPO for the treatment of renal anemia in patients on peritoneal dialysis. Methods Patients on peritoneal dialysis for at least 3 years receiving stable rHuEPO therapy were shifted to darbepoetin alfa administered every week, or every other week, using the recommended 200:1 conversion factor. The doses of darbepoetin alfa were titrated to maintain hemoglobin within ±1.0 g/dL of patients’ baseline values and within a range of 9.0 – 12.0 g/dL for up to 24 weeks (20-week dose titration period followed by 4-week evaluation period). The primary end point was the change in hemoglobin levels between baseline and evaluation period. Results 73 patients completed the study; mean age was 52.1 years; 30 males. Mean baseline and evaluation period hemoglobin levels were similar (9.56 ± 1.11 vs 9.73 ± 1.41 g/dL, p = 0.248). Mean rHuEPO dose was 92.9 IU/kg/week (equivalent to 0.46 μg/kg/week darbepoetin alfa), which was higher than darbepoetin alfa dose during the evaluation period (0.46 vs 0.34 μg/kg/week, p = 0.038). In addition, ferritin levels decreased (483 ± 26 vs 396 ± 19 ng/dL, p = 0.014). The other parameters, such as albumin, C-reactive protein, transferrin saturation, Kt/V, and weekly creatinine clearance showed no statistical difference between the two regimens. No serious or major adverse effects were observed with darbepoetin alfa during the study. Conclusions Using lower dosage and frequency, darbepoetin alfa effectively maintains hemoglobin levels in peritoneal dialysis patients previously maintained on erythropoietin beta. Similar effects on hemoglobin can be maintained with even lower levels of ferritin during darbepoetin alfa use. These results show that darbepoetin alfa is safe, effective, and convenient in treating renal anemia in peritoneal dialysis patients.

Conversion from Recombinant Human Erythropoietin to Once Every 4 Weeks Darbepoetin Alfa for Treatment of Renal Anemia in CAPD Patients

2007 ◽  
Vol 9 (2) ◽  
pp. 77-81
Author(s):  
Hon-Lok Tang ◽  
Ka-Shun Fung ◽  
Kwok-Hong Chu ◽  
William Lee ◽  
Au Cheuk ◽  
...  
Keyword(s):  
Darbepoetin Alfa ◽  
Recombinant Human Erythropoietin ◽  
Renal Anemia ◽  
Human Erythropoietin

Effects of Recombinant Human Erythropoietin on Functional and Injury Endothelial Markers in Peritoneal Dialysis Patients

1999 ◽  
Vol 19 (2_suppl) ◽  
pp. 161-166 ◽  
Author(s):  
Abelardo Aguilera ◽  
Rafael Selgas ◽  
M. Luisa Ruiz-Caravaca ◽  
M. Auxiliadora Bajo ◽  
M. Vicenta Cuesta ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Endothelial Function ◽  
Recombinant Human Erythropoietin ◽  
Venous Occlusion ◽  
Endothelial Damage ◽  
Tissue Type ◽  
Clinical Effects ◽  
Dialysis Patients ◽  
Human Erythropoietin ◽  
Long Term Treatment

Clinical effects of recombinant human erythropoietin (rHuEPO) such as thrombosis, convulsions, hyperviscosity, hypertension, and angiogenic effect in culture cells have been described. We studied the rHuEPO effect on endothelial damage markers and endothelial function markers: tissue-type plasminogen activator (t-PA), nitrate (NO3), thrombomodulin (TM), and von Willebrand factor (vWF). Twenty-six peritoneal dialysis patients treated with rHuEPO and 19 controls were included. The study design for rHuEPO patients consisted of four periods: long-term treatment (rHuEPO-1); 2 months of withdrawal (rHuEPO-2); and 4 months on 5000 IU/week rHuEPO subcutaneously, with markers being measured after 2 months (rHuEPO-3) and after 4 months (rHuEPO-4). After 2 months of rHuEPO withdrawal, a decrease in hemoglobin level appeared (11 ± 1.8 g/dL to 9.2 ± 1.5 g/dL, p < 0.01). After rHuEPO reintroduction, this value reached 10.6 ± 1.5 g/dL at two months, and 11.1 ± 1.4 g/dL at four months. A significant increase in t-PA ratio was observed from two months without rHuEPO to two months on rHuEPO, returning to previous values after four months. Similarly, TM increased for patients with creatinine clearances (CrC) < 5 mL/min. No changes in the higher-thannormal plasma vWF levels were found during the various periods. A statistically significant lower value was found in controls compared with rHuEPO-4 patients. A statistically significant increase in NO3 levels was observed in the pre-venous occlusion (VO) test immediately after the re-introduction of rHuEPO. This increment returned to prior values four months after rHuEPO was reintroduced. Our results show that rHuEPO treatment causes an increase in some endothelial damage markers (TM, t-PA) and modifies endothelial function markers (t-PA ratio, NO3). These changes might favor thrombosis and atherosclerosis.

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