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Subcutaneous epoetin beta in renal anemia : An open multicenter dose titration study of patients on continuous peritoneal dialysis

Barany, P.; Clyne, N. LU ; Hylander, B.; Johansson, A. C.; Simonsen, O. LU ; Larsson, R.; Frisenette-Fich, C.; Svensson, B. and Helmers, C. (1995) In Peritoneal Dialysis International 15(1). p.54-60
Abstract

Objective: To establish dose requirements (target hemoglobin > 100 g/L) and safety of subcutaneously administered epoetin beta. Design: Open multicenter study. Patients: Forty-five anemic patients (21 female, 24 male; mean age 55 years; range 20-79 years) who had been on continuous peritoneal dialysis for 1-157 months (mean 24 months). Thirty patients required blood transfusions during the year prior to the study. Mean hemoglobin concentration pretreatment was 75 g/L (range 57-89 g/L). Intervention: After a pretreatment period of tyro weeks, 60 IU kg-1 week-1 divided into three weekly doses of epoetin beta was administered subcutaneously. The dose was increased by 60 IU kg-1 week-1 after... (More)

Objective: To establish dose requirements (target hemoglobin > 100 g/L) and safety of subcutaneously administered epoetin beta. Design: Open multicenter study. Patients: Forty-five anemic patients (21 female, 24 male; mean age 55 years; range 20-79 years) who had been on continuous peritoneal dialysis for 1-157 months (mean 24 months). Thirty patients required blood transfusions during the year prior to the study. Mean hemoglobin concentration pretreatment was 75 g/L (range 57-89 g/L). Intervention: After a pretreatment period of tyro weeks, 60 IU kg-1 week-1 divided into three weekly doses of epoetin beta was administered subcutaneously. The dose was increased by 60 IU kg-1 week-1 after ten weeks, and when necessary, every fourth week in patients with hemoglobin levels below 100 g/L. Main Outcome Measures: Hemoglobin concentration. Analysis of factors affecting the response to epoetin beta. Safety of epoetin beta. Results: Thirty-eight of the 45 patients completed six months and 21 patients completed one year in the study. Twenty-six patients reached hemoglobin 100 g/L within six months and 8 patients did later on. The mean hemoglobin concentration after three months was 93 g/L (range 64-144 g/L) and after six months was 99 g/L (range 59-130 g/L; mean epoetin beta dose 122 IU kg-1 week-1). During the second six-month period of the study, hemoglobin levels were stable in most patients. After one year, the mean hemoglobin was 110 g/L (range 84-153 g/L) and the mean epoetin beta dose was 107 IU kg-1 week-1. Prolonged correction time and impaired response to epoetin were observed in patients with infections or hemorrhages and in patients with low hemoglobin concentration before starting epoetin treatment. Iron deficiency was controlled by iron supplementation either orally or, in 10 patients, intravenously. Increased blood pressure, requiring intensified antihypertensive treatment, was observed in 13 patients. Conclusions: Continuous peritoneal dialysis patients with moderate anemia (Hb 75-90 g/L) and without complicating disorders can be managed with subcutaneous doses of epoetin <120 IU kg1 week1. The epoetin beta dose should be adjusted after the first month of treatment since most patients required higher doses than the initial 60 IU kg-1week-1.

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author
publishing date
type
Contribution to journal
publication status
published
keywords
Anemia, Chronic renal failure, Erythropoietin, Peritoneal dialysis
in
Peritoneal Dialysis International
volume
15
issue
1
pages
7 pages
publisher
Multimed Inc.
external identifiers
  • Scopus:0028966230
ISSN
0896-8608
language
English
LU publication?
no
id
5c96df2f-7839-4ffd-aa16-137783c98bb8
date added to LUP
2016-08-30 22:02:04
date last changed
2016-09-16 15:09:52
@misc{5c96df2f-7839-4ffd-aa16-137783c98bb8,
  abstract     = {<p>Objective: To establish dose requirements (target hemoglobin &gt; 100 g/L) and safety of subcutaneously administered epoetin beta. Design: Open multicenter study. Patients: Forty-five anemic patients (21 female, 24 male; mean age 55 years; range 20-79 years) who had been on continuous peritoneal dialysis for 1-157 months (mean 24 months). Thirty patients required blood transfusions during the year prior to the study. Mean hemoglobin concentration pretreatment was 75 g/L (range 57-89 g/L). Intervention: After a pretreatment period of tyro weeks, 60 IU kg<sup>-1</sup> week<sup>-1</sup> divided into three weekly doses of epoetin beta was administered subcutaneously. The dose was increased by 60 IU kg<sup>-1</sup> week<sup>-1</sup> after ten weeks, and when necessary, every fourth week in patients with hemoglobin levels below 100 g/L. Main Outcome Measures: Hemoglobin concentration. Analysis of factors affecting the response to epoetin beta. Safety of epoetin beta. Results: Thirty-eight of the 45 patients completed six months and 21 patients completed one year in the study. Twenty-six patients reached hemoglobin 100 g/L within six months and 8 patients did later on. The mean hemoglobin concentration after three months was 93 g/L (range 64-144 g/L) and after six months was 99 g/L (range 59-130 g/L; mean epoetin beta dose 122 IU kg<sup>-1</sup> week<sup>-1</sup>). During the second six-month period of the study, hemoglobin levels were stable in most patients. After one year, the mean hemoglobin was 110 g/L (range 84-153 g/L) and the mean epoetin beta dose was 107 IU kg<sup>-1</sup> week<sup>-1</sup>. Prolonged correction time and impaired response to epoetin were observed in patients with infections or hemorrhages and in patients with low hemoglobin concentration before starting epoetin treatment. Iron deficiency was controlled by iron supplementation either orally or, in 10 patients, intravenously. Increased blood pressure, requiring intensified antihypertensive treatment, was observed in 13 patients. Conclusions: Continuous peritoneal dialysis patients with moderate anemia (Hb 75-90 g/L) and without complicating disorders can be managed with subcutaneous doses of epoetin &lt;120 IU kg<sup>1</sup> week<sup>1</sup>. The epoetin beta dose should be adjusted after the first month of treatment since most patients required higher doses than the initial 60 IU kg<sup>-1</sup>week<sup>-1</sup>.</p>},
  author       = {Barany, P. and Clyne, N. and Hylander, B. and Johansson, A. C. and Simonsen, O. and Larsson, R. and Frisenette-Fich, C. and Svensson, B. and Helmers, C.},
  issn         = {0896-8608},
  keyword      = {Anemia,Chronic renal failure,Erythropoietin,Peritoneal dialysis},
  language     = {eng},
  number       = {1},
  pages        = {54--60},
  publisher    = {ARRAY(0x7ad58f8)},
  series       = {Peritoneal Dialysis International},
  title        = {Subcutaneous epoetin beta in renal anemia : An open multicenter dose titration study of patients on continuous peritoneal dialysis},
  volume       = {15},
  year         = {1995},
}