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4CPS-042 Overdose of darbepoetin in patients with chronic kidney failure. Room for improvement with pharmacist interventions
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  1. M Mir Cros1,
  2. P Taberner Bonastre1,
  3. M Bardoll Cucala1,
  4. M Cuy Bueno1,
  5. A Galindo Verdugo1,
  6. FI Torres Bondia2,
  7. SM Cano Marrón1,
  8. JF Sarró Sobrín3,
  9. LS Craver Hospital3,
  10. JA Schoenenberger Arnaiz1
  1. 1Hospital Universitari Arnau de Vilanova, Pharmacy, Lleida, Spain
  2. 2Hospital Universitari Santa Maria, Pharmacy, Lleida, Spain
  3. 3Hospital Universitari Arnau de Vilanova, Nephrology, Lleida, Spain

Abstract

Background and Importance Darbepoetin is used to treat symptomatic anaemia associated with chronic kidney failure (CKD) and to increase haemoglobin concentration to a level no higher than 12 g/dl.

Patients should be closely monitored to ensure that the lowest authorised effective dose of darbepoetin adequately controls the anemia-related symptoms while maintaining a haemoglobin concentration below or equal to 12 g/dl.

Aim and Objectives To improve the safety of darbepoetin treatment, this study aimed to identify patients with CKD and haemoglobin levels exceeding 12g/dl.

Material and Methods An observational, descriptive, and retrospective study was conducted to analyse CKD patients who received treatment with darbepoetin from January 2022 to August 2023.

Data collected included gender, date of birth, darbepoetin dosage in mcg, and haemoglobin value in g/dl.

For this study, we retrieve the data from Electronic Health Records (HER).

Results During the analysed period, darbepoetin treatment was administered to 567 CKD patients, 56% were man with a median age of 72, and 129/567 (22.7%) had haemoglobin levels above 12 g/dl.

Among these 129 patients, 86 (66.7%) had a haemoglobin value between 12 and 13.9 g/dl, 15 (11.6%) patients between 14 and 15.9 g/dl, and 2 (1.5%) patients had a haemoglobin value higher than 16 g/dl.

Furthermore, 5 (3.8%) patients with high haemoglobin values still received a dose of darbepoetin higher than 100 mcg.

Conclusion and Relevance According to the product information document, there is room to improve the safety of darbepoetin treatments as many patients continue treatment with darbepoetin even when the target haemoglobin level has been reached.

It is crucial to closely monitor patients starting darbepoetin treatment and adjust doses to achieve the desired haemoglobin level safely.

When patients pick up their medication from the hospital pharmacy, analytical haemoglobin values must be checked, and the attending pharmacists can communicate with nephrologists if patients do not fulfill the treatment criteria for darbepoetin.

Conflict of Interest No conflict of interest.

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