Comparison between Long- and Short-Acting Erythropoiesis-Stimulating Agents in the Period Required for Haemoglobin Stabilisation in Treatment of Anaemia in Patients with Chronic Kidney Disease.
Comparative studies of the potency of long- and short-acting erythropoiesis-stimulating agents (L-ESAs and S-ESAs) on erythropoietic activity in patients with chronic kidney disease without dialysis have not been performed, although L-ESAs are used in many countries. We performed a retrospective analysis of non-dialysis (ND) patients who had received L-ESA or S-ESA. More days were needed for the S-ESA-treated group (368 d) to reach the haemoglobin (Hb) reference range than for the L-ESA-treated group (126 d). Therefore, we investigated risk factors that influence the period until the Hb level reaches the reference range. Patients were classified into two groups by the period until the Hb level was stabilised within the reference range: the short- and long-term group. Two risk factors for delayed Hb stabilisation were identified: age ≥60 years; and administration of an S-ESA for initial treatment. These findings suggest that the Hb level should be carefully monitored during ESA therapy in elderly ND patients, and that the ESA dose should be increased or L-ESA therapy should be utilised to treat renal anaemia.
Department of Clinical Pharmacy, School of Medicine, Fujita Health University; 1–98 Dengakugakubo, Kutsukake, Toyoake, Aichi 470–1192, Japan; Faculty of Pharmacy, Meijo University; 150 Yagotoyama, Tempaku-ku, Nagoya 468–8503, Japan. taka-h@fujita-hu.ac.jp
Takahiro
T
Hayashi
Tadashi
T
Nagamatsu
Ayako
A
Matsushita
Tomohiro
T
Mizuno
Seira
S
Nishibe
Ayaka
A
Noguchi
Rina
R
Kato
Takahiro
T
Toda
Junko
J
Tanaka
Hiroshi
H
Takahashi
Hiroki
H
Hayashi
Yukio
Y
Yuzawa
Shigeki
S
Yamada
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000097:blood / Q000517:prevention & control*; D004920:Erythropoiesis / Q000187:drug effects*; D004921:Erythropoietin / Q000097:blood*; D005260:Female; D006397:Hematinics / Q000494:pharmacology / Q000627:therapeutic use*; D006454:Hemoglobins / Q000378:metabolism*; D006801:Humans; D016219:Immunotherapy, Adoptive; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000150:complications*; D012189:Retrospective Studies; D013997:Time Factors
D006397:Hematinics; D006454:Hemoglobins; D004921:Erythropoietin