Anemia Management in Adult Chronic Hemodialysis Patients Using Darbepoetin Alfa Protocol

✍ Scribed by Timothy Nguyen; Debra Wells

• Publisher: Wiley (John Wiley & Sons)
• Year: 2007
• Tongue: English
• Weight: 125 KB
• Volume: 36
• Category: Article
• ISSN: 0090-2934
• DOI: 10.1002/dat.20171

✦ Synopsis

Abstract

BACKGROUND

Data on darbepoetin alfa for anemia management in patients with chronic kidney disease (CKD) is scarce when compared with epoetin alfa. Clinical experiences of using darbepoetin alfa, dosing guide, and average weekly requirements are discussed in this article.

METHODS

A retrospective data analysis of 150 adult chronic hemodialysis patients was conducted for the period January 2005–May 2006. Darbepoetin alfa administration used convenient pre‐filled syringes. Dose was titrated up or down in small increments to target hemoglobin (Hgb) levels of at least 11 and less than 13 g/dL. Hgb levels were measured twice monthly with the goal of maintaining 80% of patients at the target of 11 g/dL or greater. Intravenous iron was administered to maintain serum ferritin levels between 100 and 600 ng/mL and transferrin saturation between 20% and 45%. Other parameters monitored included average weekly darbepoetin alfa dose.

RESULTS

The average percentage of patients maintained at an Hgb level of 11 g/dL or greater was: January–June 2005, 76.5% (95% CI, ± 2.56); July–December 2005, 82% (95% CI, ± 2.12); and 2006, 78.6% (95% CI, ± 2.96). The percentage of patients with an Hgb > 12 g/dL was 21%–46%. The average weekly darbepoetin alfa doses decreased from 70 ± 3 µg (January–June 2005) to 62 ± 2 µg (June–December 2005) and further decreased to 55 µg (95% CI, mean ± 1.12) in 2006.

CONCLUSIONS

Darbepoetin alfa is effective for anemia management in CKD patients. The average weekly darbepoetin alfa requirement for anemia management to target an Hgb level of 11 g/dL or greater for most adult chronic hemodialysis patients is 55 µg or less.