[Treatment of anemia in children undergoing chronic hemodialysis with recombinant human erythropoietin].
Anemia associated to chronic renal failure (CRF) is a very frequent disorder. Twenty five per cent of adult patients under hemodialysis require periodical transfusions to maintain acceptable quality of life. This anemia is due mainly to a relative deficit of erythropoietin (EPO). Thanks to recombinant DNA techniques, EPO availability has made it possible to treat this population with the hormone. Most of the reported experience has been obtained from adult patients and literature on children is scarce. For this reason, a controlled prospective trial on 18 patients (9 males and 9 females) with a mean age of 12.4 years (range 7-17) was conducted, evaluating hematimetric response, safety of treatment and effect on quality of life after one year of treatment. Seventeen patients could be evaluated; mean follow-up was of 365 days (180-323). Treatment started with an administration scheme of 25 U/kg/dose, i.v. route, three times weekly, and dose was corrected according to the hematimetric response. Target hemoglobin was set in 10 g%. Mean dose required to reach target was 101.5 +/- 37.7 U/kg/dose (50-200) three times weekly and time elapsed was of 223.3 days (175-355). Only one patient did not achieve target hemoglobin value with the maximal dose planned (200 U/kg/dose). Bone marrow biopsy in this patient showed alpha widespread fibrosis secondary to hyperparathyroidism caused by CRF. Direct correlation was found between the required rHuEPO dose and basal levels of serum alkaline phosphatase (Table 2). Results obtained in status performance on six patients showed significant increase in all the variables under analysis (Table 4).(ABSTRACT TRUNCATED AT 250 WORDS)
Rendo
P
P
BioSidus S. A., Buenos Aires, Argentina.
Biscigniano
L
L
Turconi
A
A
Sánchez Avalos
J C
JC
Greco
J
J
D000293:Adolescent; D000704:Analysis of Variance; D000740:Anemia / Q000188:drug therapy* / Q000209:etiology; D002648:Child; D004921:Erythropoietin / Q000627:therapeutic use*; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications; D008297:Male; D011446:Prospective Studies; D011994:Recombinant Proteins / Q000627:therapeutic use; D006435:Renal Dialysis
D006454:Hemoglobins; D011994:Recombinant Proteins; D004921:Erythropoietin
Tratamiento de la anemia en niños sometidos a hemodiálisis crónica con eritropoyetina humana recombinante.