Fixed dose of long-acting erythropoietic stimulating agents at higher frequency improves appetite, reduces inflammation and corrects anaemia in patients on haemodialysis
Journal
Clinical and Experimental Pharmacology and Physiology
Journal Volume
43
Journal Issue
10
Pages
875-882
Date Issued
2016
Author(s)
Liu, Wen-Sheng ; Chu, Da-Chen ; Chan, Hsiang-Lin ; Li, Szu-Yuan ; Liu, Chih-Kuang ; Yang, Chih-Yu ; Chen, Yu-Wei ; Lee, Pui-Ching ; Lin, Chih-Ching
Abstract
Anaemia is an important issue in patients undergoing haemodialysis. We aimed to identify a better dosing schedule of a fixed monthly dose of continuous erythropoietin receptor activator (CERA) in patients with chronic kidney disease (CKD) on haemodialysis. The CERA dosing schedule included 100?μg once monthly for 2?months, 50?μg twice monthly for 2?months and then 100?μg once monthly for two months. The effectiveness was determined by comparing haematocrit, nutritional status (serum protein and albumin) and inflammatory markers (tumour necrosis factor (TNF)-α, interleukin (IL)-1, IL-6 and Hepcidin) at the beginning of the study with those at the end of the study. Forty-seven out of 67 patients completed the trial. At the end, haematocrit was significantly higher (34.51 vs 33.22%, P=.004), levels of inflammatory markers were significantly lower (TNF-α (30.71 vs 35.67?ng/mL, P=.007), IL-6 (5.12 vs 7.95?ng/mL, P=.033), hepcidin (60.39 vs 74.39?ng/mL, P=.002)), blood glucose levels were significantly lower (112.40 vs 139.02?mg/dL, P=.003) and albumin was significantly higher (4.11 vs 3.98, P=.001). Patients with a better than average response had a lower initial number of red blood cells (3.3 vs 3.6?×?106/mm3, P=.025) and a lower IL-1 (3.8 vs 12.9?ng/mL, P=.01). They also had significantly lower blood glucose levels at the end. (91.3 vs 124.0?mg/dL, P=.03). We demonstrate that a fixed monthly dose of CERA at a twice monthly dosing schedule improves nutrition, reduces the inflammation and corrects anaemia in patients on haemodialysis. This finding may provide a new strategy for treating CKD-related anaemia. ? 2016 John Wiley & Sons Australia, Ltd
Subjects
anaemia; dosing strategy; erythropoietin stimulating agent; haemodialysis; inflammation; malnutrition
Other Subjects
albumin; calcium; chloride; continuous erythropoiesis receptor activator; glucose; hepcidin; interleukin 1; interleukin 6; phosphate; tumor necrosis factor; aged; albumin blood level; anemia; appetite; Article; autoanalyzer; calcium blood level; chloride blood level; chronic kidney disease; clinical article; erythrocyte; female; glucose blood level; hematocrit; hemodialysis; human; inflammation; leukocyte count; male; mean corpuscular hemoglobin; mean corpuscular volume; nutritional status; phosphate blood level; potassium blood level; thrombocyte count; treatment response
Type
journal article