RESUMO
Seventy-five non-dialized patients with chronic renal failure (CRF) and severe renal anemia were enrolled in a study, receiving r-HuEPO subcutaneously thrice weekly for 6 months. In 64 patients (85%) 7 weeks of treatment with a weekly dose of 158 U/kg were required to achieve Hb concentrations within the target range of 10 to 12 g/dl. Of the 11 patients (15%) who failed to achieve the target Hb range, none were considered to be non-responders as they were excluded for unrelated reasons prior to week 16 (8 cases), or were iron deficient (2 cases), or had bleeding complications (1 patient). Maintaining the Hb concentration at a level of 10.5 g/dl required a mean r-HuEPO dose of 92 U/kg per week. Adverse events were generally mild or moderate. The most commonly reported were hypertension (8%), viral infection/including flu-like syndrome (7%), nausea (7%), and dizziness (5%). Statistically significant increases in mean creatinine concentrations observed after 12 and 24 weeks were most likely due to the progression of renal disease. These results confirm that 50 U/kg of r-HuEPO given 3 times per week subcutaneous provide a safe and effective therapy for anemic predialysis patients.
Assuntos
Anemia/terapia , Eritropoetina/uso terapêutico , Falência Renal Crônica/complicações , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Anemia/sangue , Anemia/etiologia , Contagem de Células Sanguíneas , Eritropoetina/efeitos adversos , Feminino , Hematócrito , Hemoglobinas/análise , Humanos , Masculino , Pessoa de Meia-Idade , Proteínas Recombinantes/efeitos adversos , Proteínas Recombinantes/uso terapêuticoRESUMO
The effectiveness of recombinant human erythropoietin (r-HEPO) was tested in 15 haemodialysis patients. The dosage was started at 24 IU/kg three times weekly, as an intravenous bolus at the end of the dialysis session, and then doubled every two weeks as long as the rise in haemoglobin was less than 2 g/dl. During treatment the reticulocyte count rose from 31 +/- 5 x 10(3)/microliters to 152 +/- 11 x 10(3)/microliters after 16 weeks. The haematocrit rose from 0.24 +/- 0.01 to 0.36 +/- 0.002. At the beginning of treatment the haemoglobin level was 7.3 +/- 0.3 g/dl and rose during treatment to 11.3 +/- 0.2 g/dl. Three patients developed hypertension and in two their Cimino shunt closed. but there were no toxic side effects, organ damage, allergic reactions or antibodies against the hormone. The results show that the anaemia of patients on chronic dialysis can be treated effectively and without serious side effects with r-HEPO.