Low-dose subcutaneous recombinant erythropoietin in children with chronic renal failure. Australian and New Zealand Paediatric Nephrology Association.
In a multicentre trial, low-dose subcutaneous recombinant human erythropoietin (r-Hu EPO) was evaluated in 22 children aged 4 months to 16 years with anaemia of chronic renal failure over a 12-month period. A starting dosage of 50 U/kg twice weekly was given until a target haemoglobin of 9-11 g/dl was achieved. The dosage was increased by 50 U/kg per week, each 4 weeks, if the haemoglobin did not increase by 1 g/dl per month. When the target haemoglobin was achieved, the same weekly dosage was given as a single injection. After 10 weeks, the mean haemoglobin increased from 6.7 +/- 0.7 to 9.6 +/- 1.9 g/dl (P < 0.001) and the haematocrit from 19.8% +/- 2.4% to 29.3% +/- 6.3% (P < 0.001). By 4 months the target haemoglobin was achieved in 19 patients on 50 U/kg twice weekly and 1 patient on 75 U/kg twice weekly. Two children with severe renal osteodystrophy failed to respond to 95 U/kg and 150 U/kg twice weekly. The maintenance weekly dose of r-Hu EPO in 9 children over 4-12 months ranged between 45 and 125 U/kg. The Wechsler intelligence score increased in 11 children from 92 +/- 16 to 97 +/- 17 over the 12-month period (P = 0.007). No adverse effects were recorded. A starting dose of r-Hu EPO of 50 U/kg subcutaneously twice weekly is recommended as effective and safe for the majority of children with anaemia of chronic renal failure.
Burke
J R
JR
Princess Alexandra Hospital, Brisbane, Queensland, Australia.
D000293:Adolescent; D000740:Anemia / Q000097:blood / Q000188:drug therapy* / Q000209:etiology / Q000523:psychology; D002648:Child; D002675:Child, Preschool; D004921:Erythropoietin / Q000008:administration & dosage*; D005260:Female; D006400:Hematocrit; D006454:Hemoglobins / Q000187:drug effects / Q000378:metabolism; D006801:Humans; D007223:Infant; D007279:Injections, Subcutaneous; D007360:Intelligence; D007501:Iron / Q000097:blood; D007676:Kidney Failure, Chronic / Q000097:blood / Q000150:complications / Q000523:psychology / Q000628:therapy*; D008297:Male; D011994:Recombinant Proteins / Q000008:administration & dosage; D017582:Renal Replacement Therapy; D012189:Retrospective Studies
D006454:Hemoglobins; D011994:Recombinant Proteins; D004921:Erythropoietin; D007501:Iron