Recombinant human erythropoietin therapy in pediatric patients receiving long-term peritoneal dialysis

Abstract

We evaluated the impact of (s.c.) recombinant human erythropoietin (r-HuEPO) therapy on the hematological status, exercise capacity, and dietary intake of nine pediatric patients (mean age 12.4 +/- 3.2 years) receiving long-term peritoneal dialysis. Five children without medical illness served as controls for the exercise testing portion of the study. Following 7.9 +/- 2.8 weeks of twice weekly r-HuEPO (50 units/kg per dose), the hematocrit increased from 21.9 +/- 3.5% to 31.3 +/- 2.5% (P less than 0.001). A further increase to 33.2 +/- 3.0% occurred after 2 months of once weekly therapy. The blood transfusion requirement decreased from 0.5 transfusions per patient-month to 0.05 transfusions per patient-month (P less than 0.01). Graded exercise testing demonstrated an increase in peak oxygen consumption from 17.8 +/- 5.2 to 24.0 +/- 7.6 ml/kg per min (P less than 0.01). The oxygen consumption at anaerobic threshold increased from 13.1 +/- 3.9 to 17.1 +/- 3.5 ml/kg per min (P less than 0.02). Treadmill time increased from 5.3 +/- 1.2 to 7.5 +/- 1.3 min (P less than 0.001). In each case, the percentage improvement was significantly greater than the improvement seen in the control population. Dietary evaluation revealed no significant change in caloric or protein intake, despite a subjectively improved appetite. r-HuEPO, given by the s.c. route, corrects the anemia and improves the exercise capacity of pediatric patients receiving long-term peritoneal dialysis.