Highlights of the Annual Dialysis Conference: Chronic Kidney Disease Related-Anemia

February 18-20, 2007; Denver, Colorado

Anne G. Le, PharmD, RPh

April 02, 2007

Switching From Epoetin to Darbepoetin Alfa: Impact on Anemia Management

Francis Dumler, from William Beaumont Hospital, in Royal Oak, Michigan,^[8] presented the results of the impact of a Formulary switch from epoetin alfa to darbepoetin alfa on hemoglobin concentration in chronic hemodialysis patients. This was a prospective, longitudinal, observational study of 54 patients (mean age: 61 ± 16 years; 47% female; 30% black; 40% diabetics) treated by a single nephrologist. Median values for the quarter preceding the switch (PRE) were compared to the subsequent 3 months starting 30 days after the conversion (POST). Epoetin was administered intravenously 3 times/week and darbepoetin was administered intravenously once weekly. Results are shown in the table .

In addition, the median epoetin dose during the PRE period was 12,000 U/week and the median dabepoetin dose during the POST period was 60 mcg vs the package insert suggestion of 40 mcg/week. The conversion to darbepoetin alfa was performed according to the manufacturer's recommendation in the package insert, but because hemoglobin values fell 7%, the dosages had to be increased. In conclusion, conversion to IV darbepoetin should be calculated as 1 mcg per 200 U of epoetin.

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Cite this: Highlights of the Annual Dialysis Conference: Chronic Kidney Disease Related-Anemia - Medscape - Apr 02, 2007.

Introduction to Anemia of Chronic Kidney Disease
Novel Agents for the Treatment of Anemia of Chronic Kidney Disease
Efficacy and Safety of Methoxy Polyethylene Glycol-Epoetin Beta
Anemia Management in Predialysis Diabetics and in Those on Dialysis
Switching From Epoetin to Darbepoetin Alfa: Impact on Anemia Management
Conclusions
References

Table. Laboratory Values During the PRE and POST Periods
Laboratory Value	PRE (mean ± SEM)	POST (mean ± SEM)	P Value
BUN (mg/dL)	51 ± 2	51 ± 2	NS
URR (%)	70 ± 2	69 ± 2	NS
Hemoglobin (g/dL)	12.7 ± 0.2	11.8 ± 0.3	.0105
Iron saturation (%)	30 ± 1	28 ± 1	NS
Ferritin (ng/mL)	292 ± 64	462 ± 73	.0761

BUN = blood urea nitrogen; NS = not significant; SEM = standard error of the mean; URR = urea reduction ratio

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