[Effect of the treatment with human recombinant erythropoietin on anemia in children with end-stage kidney failure. French multicenter study]
- PMID: 8338412
[Effect of the treatment with human recombinant erythropoietin on anemia in children with end-stage kidney failure. French multicenter study]
Abstract
Background: The production of recombinant erythropoietin, has made large quantities of pure protein available for clinical studies. Published reports have concentrated on patients with end-stage renal disease, who develop transfusion-dependent anemia.
Material and methods: A total of 58 children aged less than 18 years (mean age: 11.48 +/- 4.62 years) with end-stage renal disease (hereditary in 9, congenital in 21 and acquired in 28) treated between July 1987 and February 1990, were included in the study. The mean duration of dialysis (hemodialysis in 56, peritoneal dialysis in 2) at the onset of the study was 35 +/- 28 months. 3 children had undergone bilateral nephrectomy, and 2 were infected with HIV. 54 children were given a phosphate-binder, 10 were given iron and 20 were given folic acid supplements. During the 6 months preceding the study, 51 patients received at least one blood transfusion (40 received 1 to 4 and 11 received 5 to 9 transfusions of packed red blood cells). Recombinant human erythropoietin (rHu EPO) (40 units/kg) was given intravenously three times per week for at least 6 weeks, with the exception of the first 9 patients who were given 80-100 units/kg. When the hematocrit increased less than 0.5% per week (or 3% for 6 weeks), the dose of rHu EPO was increased in stages, without exceeding 200 units/kg/injection. When the hematocrit reached 30 to 35%, the dose of rHu EPO was decreased by half, then gradually adjusted to maintain the hematocrit within this range.
Results: The mean value of reticulocytosis increased from 4.88 to 10.58% and the hematocrit increased from 19.34 to 29.95% during the study. The patients also reported that their appetites and general condition improved. The need for transfusion dramatically decreased after the first month of treatment. The main adverse effect of the rHu EPO administration was an increase in the number of patients with hypertension (31/45 versus 19/45), indicating the need for good control of blood pressure before treatment.
Conclusion: Erythropoietin treatment increases packed blood volume in a dose-dependent fashion. Most patients need no further transfusion and the quality of life clearly improves.
Similar articles
-
[Effectiveness of and tolerance to human recombinant erythropoietin in the treatment of kidney failure anemia in children undergoing continuous peritoneal dialysis. Multicenter study].Pediatrie. 1993;48(5):397-401. Pediatrie. 1993. PMID: 7777395 Clinical Trial. French.
-
National cooperative rHu erythropoietin study in patients with chronic renal failure: a phase IV multicenter study. Report of National Cooperative rHu Erythropoietin Study Group.Am J Kidney Dis. 1991 Oct;18(4 Suppl 1):24-33. Am J Kidney Dis. 1991. PMID: 1928075 Clinical Trial.
-
[Treatment of anemia in chronic hemodialysis patients with recombinant human erythropoietin: long-term results in 15 patients].Nephrologie. 1990;11(1):11-6. Nephrologie. 1990. PMID: 2374641 French.
-
Clinical efficacy of recombinant human erythropoietin in hemodialysis patients.Semin Nephrol. 1989 Mar;9(1 Suppl 1):16-21. Semin Nephrol. 1989. PMID: 2648516 Review.
-
Comparison of hemodialysis and peritoneal dialysis in the management of anemia related to chronic renal disease.Semin Nephrol. 1989 Mar;9(1 Suppl 1):9-15. Semin Nephrol. 1989. PMID: 2648520 Review.
Cited by
-
Recombinant human epoetin beta in the treatment of renal anemia.Ther Clin Risk Manag. 2007 Jun;3(3):433-9. Ther Clin Risk Manag. 2007. PMID: 18488073 Free PMC article.
-
Epoetin beta. A review of its pharmacological properties and clinical use in the management of anaemia associated with chronic renal failure.Drugs. 1996 Feb;51(2):299-318. doi: 10.2165/00003495-199651020-00008. Drugs. 1996. PMID: 8808169 Review.
Publication types
MeSH terms
Substances
LinkOut - more resources
Medical
Research Materials