Safety and efficacy of erythropoietin in children with chronic renal failure.
A prospective randomized study of the use of recombinant human erythropoietin (rHuEPO) in children with chronic renal disease was conducted to assess dosing requirements and side effects. Forty-four children with chronic renal failure, aged 4 months to 21 years, were studied. Twenty-five patients were pre dialysis, 10 on peritoneal dialysis, and 9 on hemodialysis. Patients received either 150 U/kg per week or 450 U/kg per week divided thrice weekly of rHuEPO for 12 weeks or until target hemoglobin (Hb) was attained. Dose was then adjusted to maintain a normal Hb. Eighty-two percent of patients reached target Hb by 7.9+/-5.6 weeks (mean+/-SD); 95% of patients in the high-dose group and 66% in the low-dose group reached target Hb within 12 weeks. The overall median rHuEPO dose at target Hb was 150 U/kg per week. Hemodialysis patients tended to require more rHuEPO to maintain a normal Hb (median 250 U/kg per week). Transfusion requirements and panel-reactive antibody levels decreased during the 12 weeks. Iron deficiency and/or hypertension occurred in 30% of children. In conclusion, rHuEPO at 150 U/kg per week is safe and effective in treating anemia in children with chronic renal disease.
Brandt
J R
JR
The Children's Hospital of New Mexico, Albuquergue, USA.
Avner
E D
ED
Hickman
R O
RO
Watkins
S L
SL
D000293:Adolescent; D000328:Adult; D000740:Anemia / Q000209:etiology / Q000517:prevention & control*; D001803:Blood Transfusion; D002648:Child; D002675:Child, Preschool; D003404:Creatinine / Q000097:blood; D004921:Erythropoietin / Q000009:adverse effects* / Q000627:therapeutic use*; D005260:Female; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000378:metabolism*; D008297:Male; D011446:Prospective Studies; D011994:Recombinant Proteins; D017701:Reticulocyte Count / Q000187:drug effects
D006454:Hemoglobins; D011994:Recombinant Proteins; D004921:Erythropoietin; D003404:Creatinine