Background The use of erythropoiesis-stimulating agents (ESA) in the treatment of anaemia due to chronic kidney disease (CKD) is highly variable regarding patient characteristics and doses, including the equivalence among ESAs stated in the label product.
Purpose To evaluate the use of ESAs for anaemia due to CKD in a university hospital.
Materials and Methods A descriptive, transversal study was performed in patients treated with ESAs for anaemia secondary to CKD in a university hospital over a month. The principle variable was monthly dose of ESA. Secondary aims were to assess: efficacy (defined in terms of haemoglobin levels [Hb]) and safety (defined in terms of percentage of patients with Hb >13 g/dl). Variables collected were: demographic characteristics, ESA type and dose, prescribing Service, Hb, serum creatinine (Cr), C-reactive protein, albumin, ferritin, transferrin saturation index, folate, vitamin B12 and parathyroid hormone (PTH).
Results 333 patients were included (52.6% female; median age 75.2 years). 69.1% patients were on pre-dialysis, 27.6% on haemodialysis and 3.3% on peritoneal dialysis. The prescription profile was: 23.4% epoetin, 41.4% darbepoetin α and 35.1% CERA. 97.0% prescriptions from Nephrology Service. Median [p25, p75] dose/month was: epoetin (12857 [8571, 25714] IU), darbepoetin α (86 [43, 129] mcg), CERA (75 [50, 100] mcg). Hb levels: epoetin (11.9 [11.3, 12.5] g/dl), darbepoetin α (11.9 [11.1, 12.8] g/dl), CERA (12.1 [11.0, 12.8] g/dl); p = 0.860. Patients with Hb> 13 g/dl: 11.5% epoetin, 19.6% darbepoetin α, 22.2% CERA; p = 0.639. Patients treated with CERA had more favourable levels of Cr, albumin and PTH than those treated with epoetin and darbepoetin α (p < 0.05).
Conclusions Efficacy and safety were similar for different types of ESAs. CERA dose was lower than the recommended equivalence stated in the label product for the doses of epoetin and darbepoetin α obtained, although patients treated with CERA had a better kidney function.
No conflict of interest.
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