Comparison of Efficacy of Continuous Erythropoietin Receptor Activator (CERA) In Chronic Kidney Disease Patients versus Patients on Hemodialysis, Single Center Experience. | ||
| The Egyptian Journal of Hospital Medicine | ||
| Article 16, Volume 61, Issue 1, October 2015, Pages 514-521 PDF (339.27 K) | ||
| Document Type: Original Article | ||
| DOI: 10.12816/0018755 | ||
| Author | ||
| Ayman Aly Seddik* | ||
| Department of Medicine, Faculty of Medicine Ain Shams University, Cairo, Egypt and Nephrology Department, Dubai Hospital, Dubai Health Authority. | ||
| Abstract | ||
| Background : prior to the availability of recombinant human erythropoietin (r-EPO, epoetin), patients on dialysis frequently demanded blood transfusions and excessive iron therapy, exposing them to the risks of iron overload, transmission of viral hepatitis, and sensitization, which reduced the chances of successful transplantation . Recombinant human erythropoietin has been used for more than 20 years for the treatment of renal anemia, Epoetin-Alfa and -beta representing the common traditional preparations. By the modification of the molecule's carbohydrate moiety or structure a longer duration of erythropoietin receptor stimulation was achieved. The continuous erythropoietin receptor activator C.E.R.A. once or twice a month was found sufficient to achieve serum hemoglobin target levels. This study was aimed to identify the efficacy of C.E.R.A (Methoxy polyethylene glycol-epoetin beta in achieving and maintenance of hemoglobin level in patients with chronic kidney disease and patients on regular Hemodialysis therapy. Patients and methods: 145 patients with either CKD stage 4 & 5 (e GFR < 45 ml/min) on follow up in nephrology outpatient department or on regular Hemodialysis in nephrology unit Dubai hospital. In this center, the CERA approved by the local pharmacy authority was used for treatment of anemia in chronic kidney disease monthly dose of (100 mg for 70 kg patient) and adjusted according to monthly HB level during the trial period for reaching and maintaining target HB level of 11-12.5 g/dl. Results : Patients on HD 78 patients (53.8%) and CKD patients 67 patients the mean HB level at the end of study period showed statistically significant rise in whole patient cohort with HB START (8.882 ±1.272 g/dl) and at the end of 24month (11.119±1017 g/dl) With P-value (< 0.001). HB at start was (9.013±1.298 g/dl) and (8.769±1.246) g/dl for CKD and HD respectively slightly higher in CKD group however without statistical difference (P-value 0.250). HB level at the 24 month period (end of trial period) was found statically higher in HD group (11.305±1.197g/dl) than CKD group (10.903±1.116g/dl) again without statistical significance P-value (0.038). Conclusion: It could be concluded that the long acting erythropoietin stimulating therapy using continuous erythrpoeitin receptor activator ( CERA ) as once monthly dose is effective and safe in maintaining target HB level in both CKD patients and patients on maintenance hemodialysis and there was no recorded side effects of its use either by intravenous or subcutaneous use. | ||
| Keywords | ||
| Anemia; CKD; Hemodialysis; Continuous Erythropoietin Receptor Activator (CERA) | ||
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