Treatment of renal anemia by subcutaneous erythropoietin in children with preterminal chronic renal failure

Schärer, K; Klare, B; Braun, Andrea; Dressel, Petra; Gretz, Norbert

doi:10.1111/j.1651-2227.1993.tb12607.x

Cited by 26 publications

(6 citation statements)

References 20 publications

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“…What was also particularly striking is that the GFR in our 84 patients, which had been deteriorating at a mean rate of about 1% a month before correction of the anaemia, improved or stabilized in 75% of cases after its correction. The improvement in renal function that we have seen in our CHF patients has been shown in many other studies of correction of anaemia in chronic renal failure (CRF) (Scharer et al 1993;Lopez-Gomez et al 1995;Kuriyama et al 1997;Jungers et al 1998).…”

Section: Heart Failure and Anaemiasupporting

confidence: 81%

The pathological consequences of anaemia

Silverberg¹,

Iaina²,

Wexler³

et al. 2001

Clinical &Amp; Laboratory Haematology

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Many patients with chronic diseases such as chronic renal failure, chronic inflammatory bowel disease and rheumatoid arthritis are anaemic. Recently congestive heart failure (CHF) has also been found to be associated with anaemia. In all these diseases this anaemia or chronic disease is at least partially due to excessive production of cytokines and leukotrines that interfere both with the effect of erythropoietin (EPO) at the bone marrow and the release of stored iron in the reticuloendothelial system. Treating this anaemia with subcutaneous EPO and IV iron improves the weakness, fatigue, cachexia, nutritional state, mood, cognitive function and quality of life. In the case of CHF it also improves cardiac function and patient functional class, prevents deterioration of renal function and markedly reduces hospitalization. Very few agents in medicine improve so many aspects of the patient so well and so quickly. Unfortunately (for the suffering patient) this anaemia is often ignored and goes untreated.

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Section: Heart Failure and Anaemiasupporting

confidence: 81%

The pathological consequences of anaemia

Silverberg¹,

Iaina²,

Wexler³

et al. 2001

Clinical &Amp; Laboratory Haematology

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“…Epoetin alfa is indicated for the treatment of pediatric patients aged 1 month to 16 years with anemia associated with CKD requiring dialysis. [188][189][190][191][192] The drug also has been used successfully to treat pediatric patients with anemia associated with CKD not requiring dialysis, 191,193 HIV-infected pediatric patients, 194,195 and those with cancer-associated anemia currently receiving chemotherapy. 196,197 In each of these settings, epoetin alfa administration was associated with dose-dependent increases in Hb and HCT values and decreases in transfusion requirements.…”

Section: Use In Pediatric Patientsmentioning

confidence: 99%

“…196,197 In each of these settings, epoetin alfa administration was associated with dose-dependent increases in Hb and HCT values and decreases in transfusion requirements. 191,[193][194][195][196][197] Ongoing studies are investigating the onceweekly administration of epoetin alfa to anemic pediatric patients with cancer. 198…”

Section: Use In Pediatric Patientsmentioning

confidence: 99%

Epoetin Alfa

Henry¹,

Bowers²,

Romano³

et al. 2004

Arch Intern Med

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Recombinant human erythropoietin (epoetin alfa) has been used in clinical settings for more than a decade. Its indications have expanded considerably from its original use as hormone therapy in the treatment of anemia in adults with chronic kidney disease. Since the introduction of epoetin alfa, a greater understanding of anemia pathophysiology and the interactions of erythropoietin, iron, and erythropoiesis has been elucidated. Anemia is now independently associated with increased mortality and disease progression. Potential survival benefits associated with correction of anemia in various patient populations are leading to consideration of earlier, more aggressive treatment of mild to moderate anemia with epoetin alfa. Moreover, this agent's therapeutic use may extend beyond currently accepted roles. Epoetin alfa is undergoing evaluation with promising results in a variety of new clinical settings, including anemia associated with congestive heart failure, ribavirin-interferon alfa treatment of hepatitis C virus infection, and critical illness. Preclinical studies also have established erythropoietin and its recombinant equivalent to be a pleiotropic cytokine with antiapoptotic activity and neuroprotective actions in the central nervous system. The therapeutic potential of epoetin alfa appears yet to be fully realized.

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“…Although increments in height were observed in some patients, enhanced linear growth was not a consistent finding during rhEPO administration in such patients with CRF. (52,(56)(57)(58)(59)(60) It should be noted, however, that the target hematocrit was 30% in the vast majority of these studies, thus, the potential beneficial effect of a hematocrit more close to the level present in subjects with normal renal function remains to be determined.…”

Section: Anemiamentioning

confidence: 98%

Growth Retardation in Children with Chronic Renal Failure

Kuizon

Salusky

1999

Journal of Bone and Mineral Research

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Growth retardation is a major obstacle to full rehabilitation of children with chronic renal failure (CRF). Several factors have been identified as contributors to impaired linear growth and they include protein and calorie malnutrition, metabolic acidosis, growth hormone resistance, anemia, and renal osteodystrophy. Although therapeutic interventions such as the use of recombinant human growth hormone, recombinant human erythropoietin, and calcitriol have made substantial contributions, the optimal therapeutic strategy remains to be defined. Indeed, growth failure persists in a substantial proportion of children with renal failure and those treated with maintenance dialysis. In addition, the increasing prevalence of adynamic lesions of renal osteodystrophy and its effect on growth have raised concern about the continued generalized use of calcitriol in children with CRF. Recent studies have shown the critical roles of parathyroid hormone-related protein (PTHrP) and the PTH/PTHrP receptor in the regulation of endochondral bone formation. The PTH/PTHrP receptor mRNA expression has been shown to be down-regulated in kidney and growth plate cartilage of animals with renal failure. Differences in the severity of secondary hyperparathyroidism influence not only growth plate morphology but also the expression of selected markers of chondrocyte proliferation and differentiation in these animals. Such findings suggest potential molecular mechanisms by which cartilage and bone development may be disrupted in children with CRF, thereby contributing to diminished linear growth.

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Treatment of renal anemia by subcutaneous erythropoietin in children with preterminal chronic renal failure

Cited by 26 publications

References 20 publications

The pathological consequences of anaemia

The pathological consequences of anaemia

Epoetin Alfa

Growth Retardation in Children with Chronic Renal Failure

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