Original Article

Clinical and Experimental Nephrology

, Volume 14, Issue 2, pp 158-163

First online:

Intravenously administered darbepoetin alfa once a week could maintain hemoglobin level more efficiently than once every 2 weeks in patients on hemodialysis

  • Hiroshi NagayaAffiliated withDepartment of Nephrology and Rheumatology, Tosei General Hospital
  • , Daijo InagumaAffiliated withDepartment of Nephrology and Rheumatology, Tosei General Hospital Email author 
  • , Akimitsu KitagawaAffiliated withDepartment of Nephrology and Rheumatology, Tosei General Hospital
  • , Minako MurataAffiliated withDepartment of Nephrology and Rheumatology, Tosei General Hospital
  • , Yutaka KamimuraAffiliated withDepartment of Nephrology and Rheumatology, Tosei General Hospital
  • , Kyoko HamaguchiAffiliated withDepartment of Nephrology and Rheumatology, Tosei General Hospital
  • , Miho TatematsuAffiliated withDepartment of Nephrology and Rheumatology, Tosei General Hospital
  • , Sachiyo SuzukiAffiliated withDepartment of Nephrology and Rheumatology, Tosei General Hospital
  • , Kei KurataAffiliated withDepartment of Nephrology and Rheumatology, Tosei General Hospital
    • , Yukio YuzawaAffiliated withDepartment of Nephrology, Nagoya University School of Medicine
    • , Seiichi MatsuoAffiliated withDepartment of Nephrology, Nagoya University School of Medicine

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Abstract

Background

Darbepoetin alfa, which has a much longer half-life than recombinant human erythropoietin, is used to treat renal anemia. However, there are few reports investigating the efficacy of darbepoetin alfa administered every 2 weeks (Q2W).

Methods

We performed the single-center, prospective, and randomized study in chronic hemodialysis patients. Clinically stable patients on hemodialysis were recruited, and darbepoetin alfa 15–40 μg/week was administered intravenously once a week (QW) to achieve a hemoglobin (Hb) level of 10.5–12.0 g/dl for 8 weeks prior to randomization. The patients were randomly assigned to 2 different dosing frequency groups: once a week (QW) or every 2 weeks (Q2W). We switched to a double dose in the Q2W group. We measured Hb level every 2 weeks and administered darbepoetin alfa to achieve an Hb level of 10.5–11.5 g/dl. The primary endpoints were the weekly dose of darbepoetin alfa administered at week 24.

Results

We assigned 19 and 20 patients into QW and Q2W, respectively. There were no significant differences between the groups in Hb, transferrin saturation, ferritin, and weekly dose of darbepoetin alfa at end of the baseline period. There was no significant difference in Hb level at week 24, at which time the weekly dose requirement and dose per dry body weight were much higher in the Q2W than in the QW group.

Conclusion

Administration of darbepoetin alfa Q2W could maintain Hb level similarly to to that obtained QW, but we did not confirm efficiency at a higher dose requirement or blood pressure elevation.

Keywords

Darbepoetin alfa Hemodialysis Interval of administration