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Original Paper

Switching from Epoetin Alpha to Darbepoetin Alpha in Japanese Hemodialysis Patients: Dose Conversion Ratio

Hirai T.a · Sugiya N.a · Nakashima A.a · Takasugi N.a · Yorioka N.b

Author affiliations

aDepartment of Internal Medicine, Hakuai Clinic, Kure-City, and bDepartment of Advanced Nephrology, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan

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Nephron Clin Pract 2009;111:c81

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: April 16, 2008
Accepted: June 19, 2008
Published online: December 17, 2008
Issue release date: February 2009

Number of Print Pages: 1
Number of Figures: 4
Number of Tables: 3


eISSN: 1660-2110 (Online)

For additional information: https://www.karger.com/NEC

Abstract

Background/Aims: Darbepoetin alpha is an erythropoietic agent with a 3-fold longer elimination half-life than epoetin. The recommended conversion ratio from epoetin to darbepoetin alpha is 1:200 (1 μg of darbepoetin alpha = 200 IU of epoetin), but several observations have suggested that this ratio overestimates the required dose of darbepoetin alpha. This study assessed the actual conversion ratio for stable Japanese hemodialysis patients and investigated whether darbepoetin alpha promotes uniform erythropoiesis. Methods: A total of 104 hemodialysis patients who were stable on epoetin alpha therapy at Hakuai Clinic in Japan were switched to intravenous darbepoetin alpha according to the 1:200 rule. They were followed for 24 weeks to assess changes of hemoglobin and the dose of darbepoetin alpha, as well as changes of the reticulocyte count. Results: One hundred patients completed the 24-week study and the final conversion ratio was 1:350.5. Darbepoetin alpha showed a similar effect in diabetics and nondiabetics. Data on the reticulocyte count demonstrated that darbepoetin alpha had a sustained effect on erythropoiesis. Conclusion: Darbepoetin alpha is effective for Japanese dialysis patients at a lower dose than expected.

© 2008 S. Karger AG, Basel


References

  1. Egrie JC, Browne JK: Development and characterization of novel erythropoiesis stimulating protein (Nesp). Nephrol Dial Transplant 2001;16(suppl 3):3–13.
    External Resources
  2. Macdougall IC, Gray SJ, Elston O, Breen C: Pharmacokinetics of novel erythropoiesis stimulating protein compared with epoetin alfa in dialysis patients. J Am Soc Nephrol 1999;10:2392–2395.
  3. Locatelli F, Olivares J, Walker R, Wilkie M, Jenkins B, Dewey C, Gray SJ, European/Australian NESP 980202 Study Group: Novel erythropoesis stimulating protein for treatment of anemia in chronic renal insufficiency. Kidney Int 2001;60:741–747.
  4. Bock HA, Hirt-Minkowski P, Brunisholz M, Keusch G, Rey S, von Albertini B, for the Swiss EFIXNES Trial Investigators: Darbepoetin alpha in lower-than-equimolar dosage maintains haemoglobin level in stable haemodialysis patients converting from epoetin alpha/beta. Nephrol Dial Transplant 2008;23:301–308.
  5. Allen R, Nissenson MD, Suzanne K, Swan MD, Jill S, Lindberg MD, Steven D, Soroka MD, Robert Beatey RN, Wang C, Picarello N, McDermott-Vitak A, Maroni BJ: Randomized control trial of darbepoetin alfa for the treatment of anemia in hemodialysis patients. Am J Kidney Dis 2002;40:110–118.
  6. Vanrenterghem Y, Barany P, Mann JF, Kerr PG, Wilson J, Barker NF, Gray SJ, European/Australian NESP 970200 Study Group: Randomized trial of darbepoetin alfa for treatment of renal anemia at a reduced dose frequency compared with rHuEPO in dialysis patient. Kidney Int 2002;62:2167–2175.
  7. Akizawa T, Koshikawa S, Iwasaki M, KRN321 A08 Study Group: Darbepoetin alfa effectively maintains hemoglobin concentration at extended dose intervals relative to intravenous rHuEPO in Japanese dialysis patients. Ther Apher Dial 2007;11:220–226.
  8. Nakai S: An overview of dialysis treatment in Japan (as of Dec. 31, 2006). J Jpn Soc Dial Ther 2008;1:1–28.
    External Resources
  9. Gejyo F, Saito A, Akizawa T, Akiba T, Sakai T, Suzuki M, Nishi S, Tsubakihara Y, Hirakata H, Bessho M: Japanese Society for Dialysis Therapy Guideline for Renal Anemia in Chronic Hemodialysis Patients. Ther Apher Dial 2004;8:443–459.
  10. Go I, Takemoto Y, Tsuchida K, Nakatani T: The effect of ultrapure dialysate on improving renal anemia. Osaka City Med J 2007;53:17–23.
  11. Hsu PY, Lin CL, Yu CC, Chien CC, Hsiau TG, Sun TH, Huang LM, Yang CW: Ultrapure dialysate improves iron utilization and erythropoietin response in chronic hemodialysis patients: a prospective cross-over study. J Nephrol 2004;17:693–700.
  12. Sato T, Kurosawa A, Kurihara T, Kurosawa T: Preparation of ultrapure dialysate in Japan – clinical usefulness and short-term future. Blood Purif 2004;22(suppl 2):55–59.
  13. Schiffl H, Lang SM, Bergner A: Ultrapure dialysate reduces dose of recombinant human erythropoietin. Nephron 1999;83:278–279.
  14. Hori K, Tsujimoto Y, Omori H, Taki M, Nakamura S, Shiromizu A, Suga H, Akizawa T, Koshikawa S: Randomized, controlled study of darbepoetin alfa for the treatment of anemia in hemodialysis patients. Jin to Toseki 2007;62:679–691.
  15. Gejyo F, Saito A, Akizawa T, Sakai T, Suzuki M, Nishi S, Tsubakihara Y, Hirakata H, Bessho M: Japanese Society for Dialysis Therapy guidelines for renal anemia in chronic hemodialysis patients. Ther Apher Dial 2004;8:443–459.
  16. NKF-K/DOQI Clinical Practice Guideline for Anemia of Chronic Kidney Disease: update 2000. Am J Kidney Dis 2001;37(suppl 1):S186–S211.
  17. Agarwal R, Vasavada N, Sachs NG, Chase S: Oxidative stress and renal injury with intravenous iron in patients with chronic kidney disease. Kidney Int 2004;65:2279–2289.
  18. Otaki Y, Nakanishi T, Hasuike Y, Moriguchi R, Nanami M, Hama Y, Izumi M, Takamitsu Y: Defective regulation of iron transporters leading to iron excess in the polymorphonuclear leukocytes of patients on maintenance hemodialysis. Am J Kidney Dis 2004;43:1030–1039.

Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: April 16, 2008
Accepted: June 19, 2008
Published online: December 17, 2008
Issue release date: February 2009

Number of Print Pages: 1
Number of Figures: 4
Number of Tables: 3


eISSN: 1660-2110 (Online)

For additional information: https://www.karger.com/NEC


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