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Continuous EPO receptor activator therapy of anemia in children under peritoneal dialysis

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Abstract

The short half-life of erythropoietin (rHuEPO) leads to repeated fluctuations in hemoglobin levels and the need for frequent administration. Continuous erythropoietin receptor activator (CERA) therapy has been approved for once or twice a month in adult dialysis patients. To evaluate the efficacy and safety of CERA therapy in the management of anemia in pediatric peritoneal dialysis (PD) stable PD children under twice-a-week EPO were converted to a subcutaneous CERA, scheduled every 2 weeks. The follow-up was 6 months. The primary efficacy parameter was hemoglobin > 11 g/dL. The exclusion criteria were ferritin <100 ng/ml and Hb saturation <20%. Sixteen children, aged 9.75 ± 3.6 years, including 11 boys, participated in the study. Mean Hb level at month 0 was 10.8 ± 1.9 g/dL. A decrease in hemoglobin to 10.38 ± 1 g/dL at month 2 was observed. The CERA dose was increased from 0.86 ± 0.33 to 1.67 ± 0.4 μg/kg at month 3. The target Hb level was reached by the 3rd month. The Hb level and CERA dose were 12.2 ± 1.2 and 1.6 ± 0.67 μg/kg respectively at the end of the study. No adverse events were observed during the protocol. CERA is an effective and safe therapy for maintaining hemoglobin levels when administered twice, up to once a month, in PD children. Doses required to reach target Hb were higher than published experiences in adult populations.

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Authors and Affiliations

  1. Division of Pediatric Nephrology, Faculty of Medicine, University of Chile, Luis Calvo Mackenna Children’s Hospital, Antonio Varas 360, Providencia, Santiago, Chile

    Francisco Cano, Claudia Alarcon, Marta Azocar, Carolina Lizama, Ana Maria Lillo & Angela Delucchi

  2. Nurse Renal Department, Luis Calvo Mackenna Children’s Hospital, Antonio Varas 360, Providencia, Santiago, Chile

    Mariluz Gonzalez & Patricia Arellano

  3. Epidemiology and Health Sciences Division, Clinica Alemana, Universidad del Desarrollo, Providencia, Santiago, Chile

    Iris Delgado

  4. Division of Chemistry and Pharmacy, Luis Calvo Mackenna Children’s Hospital, Antonio Varas 360, Providencia, Santiago, Chile

    Maria Teresa Droguett

Authors
  1. Francisco Cano
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  2. Claudia Alarcon
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  3. Marta Azocar
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  4. Carolina Lizama
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  5. Ana Maria Lillo
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  7. Mariluz Gonzalez
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  8. Patricia Arellano
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  9. Iris Delgado
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  10. Maria Teresa Droguett
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Correspondence to Francisco Cano.

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Cano, F., Alarcon, C., Azocar, M. et al. Continuous EPO receptor activator therapy of anemia in children under peritoneal dialysis. Pediatr Nephrol 26, 1303–1310 (2011). https://doi.org/10.1007/s00467-011-1846-5

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  • DOI: https://doi.org/10.1007/s00467-011-1846-5

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