How the Target Hemoglobin of Renal Anemia Should Be?
Renal anemia is caused by the deficiency of endogenous erythropoietin (Epo) due to renal dysfunction. We think that it is possible to slow the progression of chronic kidney disease (CKD) in case we initiate Epo early in pre-dialysis patients, especially in the non-diabetic population. Erythropoiesis stimulating agent (ESA) treatments targeting mild anemia (10-12 g/dl) can decrease the risk of occurrence of cardiovascular disease (CVD) in patients with hypertension, diabetes mellitus and congestive heart failure. As the large randomized controlled trials such as Cardiovascular Risk Reduction by Early Anemia Treatment with E...
Source: Nephron - September 19, 2015 Category: Urology & Nephrology Source Type: research
Successful treatment of a hemodialyzed patient with pure red cell aplasia associated with epoetin beta pegol therapy with cyclosporine
Abstract
A 42-year-old man with end-stage renal failure had been receiving hemodialysis therapy since April 2009. Initially, darbepoetin alfa was administered to treat his renal anemia. After treatment was switched to epoetin beta pegol, the patient’s hemoglobin levels rapidly decreased. He was diagnosed with pure red cell aplasia (PRCA) based on the results of a bone marrow examination. Epoetin beta pegol was strongly suspected to be the cause of the PRCA, and although he tested negative for anti-epoetin beta pegol antibodies, epoetin beta pegol was discontinued and cyclosporine therapy was initiated. ...
Source: CEN Case Reports - September 15, 2015 Category: Urology & Nephrology Source Type: research
A randomized controlled trial comparing darbepoetin alfa doses in red blood cell transfusion-dependent patients with low- or intermediate-1 risk myelodysplastic syndromes.
Abstract
Darbepoetin alfa (DA) is a standard treatment for anemia in lower-risk MDS. However, to date there has been no comparative study to investigate the initial dosage. We, thus, conducted a randomized controlled trial to elucidate the optimal initial dosage of DA. International Prognostic Scoring System low or intermediate-1 risk MDS patients with hemoglobin levels ≤9.0 g/dL, serum erythropoietin levels ≤500 mIU/mL, and red blood cell transfusion dependency were enrolled. Patients were randomized to receive DA either at 60, 120, or 240 μg/week for 16 weeks followed by continuous administration...
Source: International Journal of Hematology - September 1, 2015 Category: Hematology Authors: Jang JH, Harada H, Shibayama H, Shimazaki R, Kim HJ, Sawada K, Mitani K Tags: Int J Hematol Source Type: research
Cause of Death in Patients With Diabetic CKD Enrolled in the Trial to Reduce Cardiovascular Events With Aranesp Therapy (TREAT)
Conclusions In diabetic CKD, both lower baseline GFR and higher PCR are associated with higher CV and non-CV mortality rates, particularly from sudden death and infection. Efforts to improve outcomes should focus on CV disease and early diagnosis and treatment of infection. (Source: American Journal of Kidney Diseases)
Source: American Journal of Kidney Diseases - August 21, 2015 Category: Urology & Nephrology Source Type: research
[Switch of methoxy-polyethylene-glycol-epoetin beta to darbepoetin alfa in 263 dialysis patients].
Abstract
In early 2012, due to national supply disruption, the methoxy-polyethylene glycol-epoetin beta (CERA) was no longer available and has been replaced by darbepoetin alfa (DA) in all dialysis patients. Official recommendations for the replacement of one by the other is missing or unclear. On this occasion, we wanted to examine how the shift from CERA to DA was done in terms of dose conversion factor and the other factors that could have influenced the dose of DA prescribed (hemoglobin, patient weight, dose of CERA). This retrospective multicenter open conducted in six dialysis centers in Alsace is th...
Source: Annales Pharmaceutiques Francaises - July 17, 2015 Category: Drugs & Pharmacology Authors: Rieger J, Krummel T, Petitjean P, Chantrel F, Dimitrov Y Tags: Ann Pharm Fr Source Type: research
A Randomized Comparison of Once Weekly Epoetin Alfa to Extended Schedule Epoetin or Darbepoetin in Chemotherapy‐Associated Anemia
This article is protected by copyright. All rights reserved. (Source: American Journal of Hematology)
Source: American Journal of Hematology - July 6, 2015 Category: Hematology Authors: David P. Steensma, Shaker R. Dakhil, Paul J. Novotny, Jeff A. Sloan, David B. Johnson, Daniel M. Anderson, Bassam I. Mattar, Dennis F. Moore, MD, Daniel Nikcevich, Charles L. Loprinzi Tags: Research Article Source Type: research
Mortality Risk of Darbepoetin Alfa Versus Epoetin Alfa in Patients With CKD: Systematic Review and Meta-analysis
Conclusions Few trials directly comparing DPO and EPO have been conducted and follow-up was limited. In aggregate, no effect of specific erythropoiesis-stimulating agent on mortality was identified, but the confidence limits were wide and remained compatible with considerable harm from DPO. Absent adequately powered randomized trials, observational postmarketing comparative effectiveness studies comparing these erythropoiesis-stimulating agents are required to better characterize the long-term safety profiles of these agents. (Source: American Journal of Kidney Diseases)
Source: American Journal of Kidney Diseases - June 22, 2015 Category: Urology & Nephrology Source Type: research
Rationale and study design of a randomized controlled trial to assess the effects of maintaining hemoglobin levels using darbepoetin alfa on prevention of development of end-stage kidney disease in non-diabetic CKD patients (PREDICT Trial)
Conclusion
PREDICT will determine the optimum target Hb for Japanese patients with non-diabetic CKD.
(ClinicalTrials.gov No. NCT01581073). (Source: Clinical and Experimental Nephrology)
Source: Clinical and Experimental Nephrology - June 17, 2015 Category: Urology & Nephrology Source Type: research
Race and Ethnicity Influences on Cardiovascular and Renal Events in Patients with Diabetes Mellitus
Conclusion Despite similar access to care and lower CV event rates, the risk of ESRD was higher among blacks and Hispanics than whites. For blacks, but not Hispanics, this increase was independent of known attributable risk factors. (Source: American Heart Journal)
Source: American Heart Journal - May 23, 2015 Category: Cardiology Source Type: research
Fp399 * observational study on the use of darbepoetin alfa (da) in hemodialysis patients in central eastern europe
(Source: Nephrology Dialysis Transplantation)
Source: Nephrology Dialysis Transplantation - May 21, 2015 Category: Urology & Nephrology Authors: Irzyniec, T., Parikova, A., Selyutin, A., Csiky, B., Rosenberger, J., Rus, I. Tags: CHRONIC KIDNEY DISEASE. ANAEMIA Source Type: research
Population Pharmacokinetics of Darbepoetin Alfa in Conjunction with Hypothermia for the Treatment of Neonatal Hypoxic-Ischemic Encephalopathy
Conclusions
A one-compartment model successfully described the pharmacokinetics of darbepoetin alfa among hypothermic neonates treated for hypoxic-ischemic encephalopathy. Clearance decreased with increasing gestational age. (Source: Clinical Pharmacokinetics)
Source: Clinical Pharmacokinetics - May 20, 2015 Category: Drugs & Pharmacology Source Type: research
Impact of Switching From Darbepoetin Alfa to Epoetin Beta Pegol on Iron Utilization and Blood Pressure in Peritoneal Dialysis Patients
This study evaluated the efficacy of darbepoetin alfa (DA) and long‐acting epoetin beta pegol (continuous erythropoietin receptor activator, CERA) in patients on peritoneal dialysis (PD). Twenty‐nine patients who had undergone PD for at least 6 months and were iron replacement‐naïve and negative for inflammatory parameters were enrolled. Hemoglobin (Hgb) levels and blood pressure were evaluated before and after switching from DA to CERA. Percent transferrin saturation (TSAT), serum ferritin levels and blood pressure were also assessed. Twenty‐eight patients were subject to the analysis, excluding one patient with ...
Source: Therapeutic Apheresis and Dialysis - May 5, 2015 Category: Hematology Authors: Naoki Washida, Shuji Inoue, Takahiro Kasai, Keisuke Shinozuka, Koji Hosoya, Kohkichi Morimoto, Shu Wakino, Koichi Hayashi, Hiroshi Itoh Tags: Original Article Source Type: research
Longer-term Outcomes of Darbepoetin Alfa Versus Epoetin Alfa in Patients With ESRD Initiating Hemodialysis: A Quasi-experimental Cohort Study
Conclusions In incident hemodialysis patients, mortality and cardiovascular event rates did not differ between patients treated at facilities predominantly using DPO versus EPO. (Source: American Journal of Kidney Diseases)
Source: American Journal of Kidney Diseases - May 2, 2015 Category: Urology & Nephrology Source Type: research
Comparison of pain and efficacy of darbepoetin alfa and epoetin Beta pegol treatment in patients receiving peritoneal dialysis.
CONCLUSION: No significant difference in pain was found between darbepoetin alfa and CERA therapies, but a significant difference in pain was noted between administration routes, just after injection, in the CERA group. The results also suggest that a change ratio of 0.8 from darbepoetin alfa to CERA is low for managing anemia.
PMID: 25797871 [PubMed - in process] (Source: Journal of Nippon Medical School)
Source: Journal of Nippon Medical School - March 26, 2015 Category: Universities & Medical Training Authors: Otsuka T, Sakai Y, Yui S, Sukegawa M, Suzuki A, Mugishima K, Sumi Y, Otsuka Y, Tsuruoka S Tags: J Nippon Med Sch Source Type: research
Pulse pressure is not an independent predictor of outcome in type 2 diabetes patients with chronic kidney disease and anemia—the Trial to Reduce Cardiovascular Events with Aranesp Therapy (TREAT)
Pulse pressure is not an independent predictor of outcome in type 2 diabetes patients with chronic kidney disease and anemia—the Trial to Reduce Cardiovascular Events with Aranesp Therapy (TREAT)
Journal of Human Hypertension advance online publication, March 26 2015.
doi:10.1038/jhh.2015.22
Authors: S Theilade, B Claggett, T W Hansen, H Skali, E F Lewis, S D Solomon, H-H Parving, M Pfeffer, J J McMurray & P Rossing (Source: Journal of Human Hypertension)
Source: Journal of Human Hypertension - March 26, 2015 Category: Cardiology Authors: S TheiladeB ClaggettT W HansenH SkaliE F LewisS D SolomonH-H ParvingM PfefferJ J McMurrayP Rossing Source Type: research
