Safety and efficacy of erythropoietin in children with chronic renal failure

Abstract

A prospective randomized study of the use of recombinant human erythropoietin (rHuEPO) in children with chronic renal disease was conducted to assess dosing requirements and side effects. Forty-four children with chronic renal failure, aged 4 months to 21 years, were studied. Twenty-five patients were pre dialysis, 10 on peritoneal dialysis, and 9 on hemodialysis. Patients received either 150 U/kg per week or 450 U/kg per week divided thrice weekly of rHuEPO for 12 weeks or until target hemoglobin (Hb) was attained. Dose was then adjusted to maintain a normal Hb. Eighty-two percent of patients reached target Hb by 7.9+/-5.6 weeks (mean+/-SD); 95% of patients in the high-dose group and 66% in the low-dose group reached target Hb within 12 weeks. The overall median rHuEPO dose at target Hb was 150 U/kg per week. Hemodialysis patients tended to require more rHuEPO to maintain a normal Hb (median 250 U/kg per week). Transfusion requirements and panel-reactive antibody levels decreased during the 12 weeks. Iron deficiency and/or hypertension occurred in 30% of children. In conclusion, rHuEPO at 150 U/kg per week is safe and effective in treating anemia in children with chronic renal disease.

2015 Japanese Society for Dialysis Therapy: Guidelines for Renal Anemia in Chronic Kidney Disease

“…It has been shown by one report that the incidence of ESA-induced hypertension in pediatric dialysis patients was as high as~30% and that it tended to be higher in patients who received high doses of ESA [242]. In particular, a rapid increase in Hb level has been reported to cause hypertension in children [242].…”

“…In particular, a rapid increase in Hb level has been reported to cause hypertension in children [242]. Therefore, anemia in children should be gradually corrected at a moderate rate, while paying close attention to any elevation in blood pressure.…”

Darbepoetin, effective treatment of anaemia in paediatric patients with chronic renal failure

“…Therefore, dialysis patients with anaemia have an increased risk for cardiovascular morbidity and mortality [1]. Correction of anaemia through erythropoiesis stimulation leads to decreased blood transfusion requirements and anti-HLA immunisation [2], increased appetite and tolerance to exercise [3,4] and improved school performance or quality of life [5,6]. Recombinant human erythropoietin (r-HuEPO) has become the standard of care in treating anaemia associated with chronic renal failure (CRF) in adults [7][8][9] as well as in children [10,11].…”

Preoperative Use of Erythropoietin as a Mean of Blood Saving in Children with Nonsyndromic Craniosynostosis

“…В 30% случаев было зарегистрирова-но возникновение артериальной гипертензии и дефици-та железа. В результате авторы высказали утверждение о безопасном и эффективном применении эритропоэти-на у детей [48].…”