title: De novo once-monthly darbepoetin alpha treatment for the anemia of chronic kidney disease using a computerized algorithmic approach.
abstract: BACKGROUND
  Anemia of chronic kidney disease (CKD) has been traditionally treated by erythropoiesis-stimulating agents (ESAs) and/or iron following manual determination of dose. We hypothesized that once-monthly (QM) algorithmically dosed darbepoetin α (DA) and iron administration would successfully treat anemia of CKD in ESA-naïve CKD subjects.
  
  
  METHODS
  QM DA and iron doses were determined via a computerized program targeting a hemoglobin (Hb) of 10.5 - 12.5 g/dl in anemic, ESA-naïve, CKD Stages 3 - 5 subjects. Six consecutive QM doses were administered. Hb, ferritin, and transferrin saturation were recorded. Data are presented as means ± standard deviation.
  
  
  RESULTS
  Anemia was identified in 133 subjects, with a mean follow-up of 188 days. DA doses and Hb were significantly greater at Months 3 and 6 compared to baseline (p < 0.05); DA doses were 109 ± 68 μg and 118 ± 91, respectively, at Months 3 and 6. Hemoglobin levels were correspondingly 11.3 ± 1.1 g/dl and 11.3 ± 1.0. 78% of patients achieved the target Hb by 6 months of therapy. The elevation of Hb was greater in non-proteinuric than proteinuric subjects at 6 months of treatment (11.6 ± 0.8 g/dl vs. 11.0 ± 1.1; p < 0.05), despite lower DA dose (96 ± 76 μg vs. 139 ± 98; p < 0.05).
  
  
  CONCLUSIONS
  Successful treatment of the anemia of CKD by QM DA based upon a computerized dosing program was achieved by 6 months in 78% of ESA-naïve, CKD subjects.
authors: Henry Ford Hospital, Division of Nephrology and Hypertension, Detroit, MI 48202, USA. echalho1@hfhs.org
authors: E
authors: E
authors: Chalhoub
authors: S
authors: S
authors: Frinak
authors: G
authors: G
authors: Zasuwa
authors: M D
authors: MD
authors: Faber
authors: E
authors: E
authors: Peterson
authors: A
authors: A
authors: Besarab
authors: J
authors: J
authors: Yee
mesh_terms: D000465:Algorithms; D000740:Anemia / Q000097:blood / Q000188:drug therapy* / Q000209:etiology; D002908:Chronic Disease; D000068256:Darbepoetin alfa; D004334:Drug Administration Schedule; D004360:Drug Therapy, Computer-Assisted; D004921:Erythropoietin / Q000008:administration & dosage / Q000031:analogs & derivatives*; D005260:Female; D005293:Ferritins / Q000032:analysis; D005296:Ferrous Compounds / Q000008:administration & dosage; D006397:Hematinics / Q000008:administration & dosage*; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007674:Kidney Diseases / Q000150:complications*; D008297:Male; D014168:Transferrin / Q000032:analysis
chemical_list: D005296:Ferrous Compounds; D006397:Hematinics; D006454:Hemoglobins; D014168:Transferrin; D004921:Erythropoietin; D000068256:Darbepoetin alfa; C020748:ferrous sulfate; D005293:Ferritins