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:10.1007/bf00866359

Cited by 6 publications

(11 citation statements)

References 5 publications

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“…This confirms previous results in adult [5 -13] and pediatric [14,15,18] predialysis patients. Signs of iron deficiency were observed in most children during EPO administration, despite continuing oral iron administration, which might explain the delayed response in some patients.…”

Section: Discussionsupporting

confidence: 94%

“…Six patients (nos. 1, 5, 6, 9, 10, and 11 in Tables 1 and 2) have been reported earlier [15]. All selected children had a history of progressive CRF and a minimal observation period of 8 months before and 10 months after the start of EPO treatment.…”

Section: Methodsmentioning

confidence: 94%

“…A retrospective analysis was performed in 11 children (9 boys, 2 girls) with preterminal CRF (Table 1, 2) who underwent EPO treatment according to a fixed protocol [15]. These children were selected from a total of 20 who started s. c. EPO therapy for preterminal CRF during the study period (1990 -1993).…”

Section: Methodsmentioning

confidence: 99%

“…Investigations in adult patients have indicated that EPO treatment is also efficient and safe prior to initiation of renal replacement therapy [5 -13]. This was confirmed in children with predialysis CRF [14,15]. However, the influence of long-term EPO treatment on renal function in predialysis patients is controversial.…”

Section: Introductionmentioning

confidence: 96%

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Renal function in predialysis children with chronic renal failure treated with erythropoietin

Krmar¹,

Gretz

Klare

et al. 1997

Pediatric Nephrology

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To assess the effect of long-term administration of human recombinant erythropoietin (EPO) on renal function, 11 anemic children aged 1.4-17.2 years were followed for 10-61 (mean 31) months on treatment. During EPO therapy the mean hemoglobin rose from 8.1 to 11.1 g/dl at the last observation. The final maintenance dose ranged between 70 and 300 U/kg per week. The rate of deterioration of renal function was calculated by comparing the slope of the regression lines of reciprocal serum creatinine values (SCr) derived from a mean of 20 values per patient obtained over 8-50 (mean 29) months before and a mean of 24 SCR values during EPO therapy. The individual slopes improved after initiation of EPO therapy in all but 3 patients, but the mean change of slope (from -0.0521 to -0.0299) was not significant. The study suggests that in most children with predialysis chronic renal failure long-term administration of EPO is not associated with accelerated deterioration but rather with delayed deterioration of renal function.

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Section: Discussionsupporting

confidence: 94%

Section: Methodsmentioning

confidence: 94%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 96%

See 2 more Smart Citations

Renal function in predialysis children with chronic renal failure treated with erythropoietin

Krmar¹,

Gretz

Klare

et al. 1997

Pediatric Nephrology

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“…However, rHuEpo treatment could be ± at least transiently ± stopped in 2 boys, when their graft function improved. Such influences are less likely in the rather uniform progression of most primary renal diseases [16], and are virtually undescribed in children on dialysis [10 ± 12]. Chronic covert and overt blood losses constitute another risk factor for decreasing hematocrit [17].…”

Section: Discussionmentioning

confidence: 99%

Subcutaneous recombinant human erythropoietin in chronic renal allograft dysfunction

1998

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We investigated the efficacy and safety of subcutaneous recombinant human erythropoietin (rHuEpo) in 25 children with chronic renal allograft dysfunction (13 girls, 12 boys, mean age 15.8 +/- 4.2 years) for a treatment period of 9-162 (median 43) weeks. rHuEpo was started once weekly at a dose of 105 +/- 25 U/kg per week in 16 children, twice weekly at a dose of 175 +/- 70 U/kg per week in 6 children, and three times weekly at a dose of 270 +/- 28 U/kg per week in 3 children. The hematocrit increased in 21 children from 23.2% +/- 3.1% to 33% +/- 3.1% within 7.2 +/- 4.9 weeks at a mean rate of 1.98%/week. The hematocrit increase and rHuEpo starting dose were linearly related (delta hematocrit/week = 0.8+0.08 U/kg per week, r = 0.44, P < 0.05). The maintenance dose was 74 +/- 23 (43-114) U/kg per week. Four children failed to reach the target hematocrit, most likely due to noncompliance. Seventeen recurrences of anemia ("anemic episodes") during rHuEpo therapy were identified in 12 children, mostly associated with acute or insidious deteriorations in graft function. There was no acceleration of progression of graft dysfunction with rHuEpo treatment. We conclude that subcutaneous rHuEpo at a single weekly dose of 100 IU/kg per week is highly effective in children with chronic graft dysfunction. Children who appear to be rHuEpo resistant or experience rHuEpo-resistant episodes should be assessed for noncompliance, changes in graft function since the last dosage adjustment, and blood loss, such as seen in dysfunctional uterine bleeding in adolescent girls.

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

Cited by 6 publications

References 5 publications

Renal function in predialysis children with chronic renal failure treated with erythropoietin

Renal function in predialysis children with chronic renal failure treated with erythropoietin

Subcutaneous recombinant human erythropoietin in chronic renal allograft dysfunction

Epoetin Alfa

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