LONG-ACTING ERYTHROPOETIN EFFICACY IN THE TREATMENT OF NEPHROGENIC ANEMIA IN PATIENTS WITH CHRONIC KIDNEY DISEASE AT A PREDIALYSIS STAGE


Cite item

Abstract

Aim. Comparison of efficacy of 12-month treatment of anemia in patients with chronic kidney disease (CKD) of stage III — IV with a long-acting drug darbepoetin alpha — aranesp and short-acting drug erythropoietin beta — recormon. Material and methods. A total of 44 patients with CKD of stage III-IV were divided into two groups. Of them, 24 had chronic glomerulonephritis and 20 had tubulointerstitial nephritis with verified nephrogenic anemia. Group 1 consisted of 22 patients given long-acting erythropoetin (darbepoetin alpha) in an initial dose 0,75 mcg/kg each 2 weeks subcutaneously. Group 2 consisted of 22 patients matched by age, gender, severity of anemia and renal failure with group 1 patients given short-acting erythropoietin (erythropoietin beta) in an initial 20 IU 3 times a week subcutaneously for 12 months. In the phase of anemia correction and supporting therapy, the levels of packed red blood cells, Hb, free serum ferrum, ferritin, percentage of iron in transferrin, serum albumin in blood serum, creatinin, glomerular filtration rate were examined monthly. The patients themselves daily measured blood pressure, diuresis, body mass. Results. The target level of Hb 110-120 g/l was achieved faster in group 2 than in group 1 (3 and 4 months, respectively), p < 0.05). In the phase of supporting a target Hb level, on the opposite, darbepoetin alpha provided more stable hemopoetin effect than erythropoietin beta, darbepoetin alpha median dose being constant in the course of the study.

About the authors

Yu S Milovanov

I.M. Sechenov Moscow State Medical University, University hospital N 3

Email: yumil2010@rambler.ru
д-р мед. наук, вед. науч. сотр. отд. нефрологии Москва

L Yu Milovanova

I.M. Sechenov Moscow State Medical University, University hospital N 3

Email: lussya2000@mail.ru
канд. мед. наук, врач-нефролог консультативно-поликлинического отд-ния Москва

References

  1. McClellan W., Aronoff S.L., Bolton W.K. et al. The prevalence of anemia in patients with chronic kidney disease. Curr. Med. Res. Opin. 2004; 20: 1501—1510.
  2. Orbador G. T., Roberts T., St. Peter W. L. Trends in anemia at initiator of dialysis in the United States. Kidney Int. 2001; 60: 1875—1884.
  3. Bansal N., Tighiouart H., Weiner D. et al. Anemia as a risk factor for kidney function decline in individuals with heart failure. Am. J. Cardiol. 2007; 99: 1137—1142.
  4. Tong P. C., Kong A. P., So W. Y. et al. Hematocrit, independent of chronic kidney disease, predicts adverse cardiovascular outcomes in Chinese patients with type 2 diabetes. Diabet. Care 2006; 29: 2439—2444.
  5. Kovesdy C. P., Trivedy B. K., Kalantar-Zaden K., Anderson J. E. Association of anemia with outcomes in men with moderate and severe chronic kidney disease. Kidney Int. 2006; 69: 560—564.
  6. Li S., Foley R. N., Collins A. J. Anemia and cardiovascular disease, hospitalization, and stage renal disease, and death in older patients with chronic kidney disease. Int. Urol. Nephrol. 2005; 37 (2): 395—402.
  7. Thorp M. L., Jonson E. S. Effect of anemia on mortality? Cardiovascular hospitalization? And stage renal disease among patients with chronic renal disease. Nephrology 2009; 14: 240— 246.
  8. Locatelli F., Covic A., Eckardt K. U. et al. Anaemia management in patients with chronic kidney disease: a position statement by the Anaemia Working Group of European Renal Best Practice (ERBP). Nephrol. Dial. Transplant. 2009; 24: 348—354.
  9. De Francisco A. L., Pinera C. Anemia trials in CKD and clinical practice: refining the approach to erytropoesis-stimulating agents. Contrib. Nephrol. 2011; 31 (3): 241—246.
  10. Locatelli F., Aljama P., Canaud B. et al. Target haemoglobin to aim for with erytropoiesis-stimulating agents: a position statement by ERBP following publication of the Trial to Reduce Cardiovascular Events with Aranesp Therapy (TREAT) Study. Nephrol. Dial.Transplant. 2010; 25: 2846—2850.
  11. Ebben J. P., Gilbertson D. T., Foley R. N., Collins A. J. Hemoglobin level variability: association with comorbidity, intercurrent events, and hospitalizations. Clin. J. Am. Soc. Nephrol. 2006: 1: 1205—1210.
  12. Gilbertson D., Ebben J., Foley R. N. Hemoglobin level variability: association with mortality. Clin. J. Am. Soc. Nephrol. 2008; 3: 133—138.
  13. Feldman H.I., Israni R.K., Yang W. et al. Hemoglobin variability and mortality among hemodialysis patients. J. Am. Soc. Nephrol. 2006: 17: 583A (abstr. SA-PO034).
  14. Козловская Л. В., Милованов Ю. С., Милованова Л. Ю., Добросмыслов И. А. Трудности лечения почечной анемии. Место активаторов рецепторов эритропоэтина длительного действия. Клин. нефрол. 2010; 2: 23—27.
  15. Fishbane S., Berns J. S. Hemoglobin cycling in hemodialysis patients treated with recombinant human erythropoietin. Kidney Int. 2005; 68: 1337—1343.
  16. Eckardt K. U., Kim J., Kronenberg F. et al. Hemoglobin variability does not predict mortality in European hemodialysis patients. J. Am. Soc. Nephrol. 2010; 21: 25—30.
  17. Ofsthun N. J. The association of mortality and hospitalization with haemoglobin and missrd dialysis treatments in stage 5 CKD patients with and without cardiac comorbidities. Nephrol. Dial. Transplant. 2005; 20 (Suppl. 5): 35—43.
  18. Ishani A., Guo H., Gilbertson D.T. et al. Time to target haemoglobin concentration (11g/dL): risk of hospitalization and mortality among incident dialysis patients. Nephrol. Dial. Transplant. 2007; 22: 2247—2255.
  19. Macdougall I. C., Walker R., Provenzano R. et al. ASRCTOS Study Investigators. C. E. R. A. corrects anemia in patients with chronic kidney disease not on dialysis: results of a randomized clinical trial. Clin. J. Am. Soc. Nephrol. 2008; 3 (2): 337—347.
  20. Nissenson A. R., Swan S. K., Lindberg J. S. et al. Randomized, controlled trial of darbepoetin alfa for the treatment of anemia in hemodialysis patients. Am. J. Kidney Dis. 2002; 40: 110—118.
  21. Egrie J. C., Browne J. K. Development and characterization of novel erytropoiesis stimulating protein. Nephrol. Dial. Transplant. 2001; 16 (Suppl. 3): 3—13.
  22. Agarwal A., Silver M. R., Reed J. E. et al. An open-lebel study of darbepoetin alfa administered once monthly for the maintenance of hemoglobin concentrations in patients with chronic kidney disease not receiving dialysis. J. Int. Med. 2006; 260: 577—585.
  23. Toto R. D., Pichette V., Navarro J. et al. Darbepoetin alfa effectively treats anemia in patients with chronic kidney disease with de novo every other-week administration. Am. J. Nephrol. 2004; 24: 453—460.
  24. Carrera F., Oliveira L., Maia P. et. al. The intravenous darbepoetin alfa administered once every 2 weeks in chronic kidney disease patients on hemodialysis. Nephrol. Dial. Transplant. 2006; 21: 2846—2850.
  25. Molina M., Garcia Hemandez M. A., Narraro M. J. et al. Estudio comparative sobre et tratamiento de la anemia renal en el pacien-teen hemo dialysis cambio de via de administraci en de epoetina alfa frente a conversion a darbepoetina. Nefrologia 2004; 14: 564—571.
  26. Wiesholzer M. Switch from rHuEPO to darbepoetin alfa in hemodialysis patients in a clinical setting. Nephrol. Dial. Transplant. 2006; 21 (Suppl. 4): iv154—iv155.
  27. Милованов Ю. С. Нефропротективная стратегия у больных ХБП на додиализном этапе. Berlin: Lambert Academic Publishing; 2011.
  28. Locatelli F., Nissenson A. R., Barrett B. J. et al. Clinical practice guidelines for anemia in chronic kidney disease: problems and solutions. A position statement from Kidney Disease Improving Global Outcomes (KDIGO). Kidney Int. 2008; 74: 1237—1240.
  29. Fishbane S., Berns J. S. Hemoglobin cycling in hemodialysis patients treated with recombinant human erythropoietin. Kidney Int. 2005; 68: 1337—1343.
  30. Roche date on file. Date on file. 2007.
  31. Tolman S., Richardson D., Bartlett C., Will E. Structured conversion from thrice weekly to weekly erythropoietic regiments using a computerized decision support system: a randomized clinical study. J. Am. Soc. Nephrol. 2005; 16: 143—147.

Supplementary files

Supplementary Files
Action
1. JATS XML

Copyright (c) 2012 Consilium Medicum

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
 
 


Согласие на обработку персональных данных

 

Используя сайт https://journals.rcsi.science, я (далее – «Пользователь» или «Субъект персональных данных») даю согласие на обработку персональных данных на этом сайте (текст Согласия) и на обработку персональных данных с помощью сервиса «Яндекс.Метрика» (текст Согласия).