Pediatric Nephrology

, Volume 26, Issue 8, pp 1303–1310

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

  • Francisco Cano
  • Claudia Alarcon
  • Marta Azocar
  • Carolina Lizama
  • Ana Maria Lillo
  • Angela Delucchi
  • Mariluz Gonzalez
  • Patricia Arellano
  • Iris Delgado
  • Maria Teresa Droguett
Original Article

DOI: 10.1007/s00467-011-1846-5

Cite this article as:
Cano, F., Alarcon, C., Azocar, M. et al. Pediatr Nephrol (2011) 26: 1303. doi:10.1007/s00467-011-1846-5

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.

Keywords

Erythropoietin EPO CERA Anemia Children Peritoneal dialysis 

Copyright information

© IPNA 2011

Authors and Affiliations

  • Francisco Cano
    • 1
  • Claudia Alarcon
    • 1
  • Marta Azocar
    • 1
  • Carolina Lizama
    • 1
  • Ana Maria Lillo
    • 1
  • Angela Delucchi
    • 1
  • Mariluz Gonzalez
    • 2
  • Patricia Arellano
    • 2
  • Iris Delgado
    • 3
  • Maria Teresa Droguett
    • 4
  1. 1.Division of Pediatric Nephrology, Faculty of Medicine, University of ChileLuis Calvo Mackenna Children’s HospitalProvidenciaChile
  2. 2.Nurse Renal DepartmentLuis Calvo Mackenna Children’s HospitalProvidenciaChile
  3. 3.Epidemiology and Health Sciences Division, Clinica AlemanaUniversidad del DesarrolloProvidenciaChile
  4. 4.Division of Chemistry and PharmacyLuis Calvo Mackenna Children’s HospitalProvidenciaChile

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