title: The Use of Darbepoetin to Stimulate Erythropoiesis in the Treatment of Anemia of Chronic Kidney Disease in Dogs.
abstract: BACKGROUND
  Darbepoetin alfa (darbepoetin) is an erythropoiesis-stimulating agent used for the treatment of anemia secondary to chronic kidney disease (CKD) in dogs, but reports describing response are lacking.
  
  
  OBJECTIVE
  To evaluate the effectiveness of darbepoetin in dogs with anemia secondary to CKD, dosing protocols, and adverse events.
  
  
  METHODS
  Thirty-three client-owned dogs with naturally occurring CKD, including 26 with comorbidities.
  
  
  METHODS
  Multi-institutional retrospective study.
  
  
  RESULTS
  The median starting dosage and highest dosage of darbepoetin administered were 0.5 and 0.8 μg/kg SC once weekly, respectively. Response to treatment was defined as achieving a packed cell volume (PCV) ≥30% or an increase in PCV ≥10%. Twenty-eight of 33 dogs (85%) achieved a PCV ≥30% and 22 of 33 (67%) dogs achieved an increase in PCV ≥10%. Median time to achieve a PCV ≥30% was 29 days. A higher starting dosage was associated with achieving an increase in PCV ≥10% (P = .01). No dog sustained a response at a dosing interval >q21d. Potential adverse events included increased blood pressure requiring treatment (n = 12), seizures (n = 5), vomiting (n = 3), diarrhea (n = 3), and possible pure red cell aplasia (PRCA) (n = 2).
  
  
  CONCLUSIONS
  Darbepoetin, when combined with treatment of comorbidities, is an effective treatment for anemia secondary to CKD in dogs. A dosing interval >q21d was ineffective at maintaining a response to treatment. PRCA was a possible adverse event in 2 of 33 dogs (6%).
authors.affiliation: Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA.
authors.forename: E H
authors.initials: EH
authors.lastname: Fiocchi
authors.affiliation: Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California-Davis, Davis, CA.
authors.forename: L D
authors.initials: LD
authors.lastname: Cowgill
authors.affiliation: Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA.
authors.forename: D C
authors.initials: DC
authors.lastname: Brown
authors.affiliation: Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA.
authors.forename: J E
authors.initials: JE
authors.lastname: Markovich
authors.affiliation: Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA.
authors.forename: S
authors.initials: S
authors.lastname: Tucker
authors.affiliation: Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA.
authors.forename: M A
authors.initials: MA
authors.lastname: Labato
authors.affiliation: Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA.
authors.forename: M B
authors.identifier: http://orcid.org/0000-0002-4508-9980
authors.initials: MB
authors.lastname: Callan
mesh_terms: D000740:Anemia / Q000188:drug therapy / Q000662:veterinary*; D000818:Animals; D000068256:Darbepoetin alfa / Q000009:adverse effects / Q000627:therapeutic use*; D004283:Dog Diseases / Q000097:blood / Q000188:drug therapy*; D004285:Dogs; D004920:Erythropoiesis / Q000187:drug effects; D005260:Female; D006397:Hematinics / Q000009:adverse effects / Q000627:therapeutic use*; D006400:Hematocrit / Q000662:veterinary; D008297:Male; D012010:Red-Cell Aplasia, Pure / Q000139:chemically induced / Q000662:veterinary; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000662:veterinary*; D012189:Retrospective Studies
chemical_list: D006397:Hematinics; D000068256:Darbepoetin alfa
keywords: Erythropoietin; Iron; Pure red cell aplasia; Renal disease