Recombinant human erythropoetin in children with chronic renal failure

Abstract

Recombinant human erythropoetin (r-Hu Epo) was administered to six children with chronic renal failure (creatinine clearance < 30 ml/m/1.73 m2). Two of these children suffered from terminal renal failure and received continuous ambulatory peritoneal dialysis (CAPD) An initial dose of 150 μ/kg BW/week r-Hu-Epo was administered subcutaneously. The dose was increased by 75 μ/kg BW/week and maintained when the hemoglobin level reached 10 g/dl. The hemoglobin level rose from 6.93 ± 1.76 g/dl before treatment to 8.45 ±1.77 g/dl after 4 weeks and 8.78 ± 2.69 g/dl after 8 weeks of treatment to 26.42 ± 7.07% after 4 weeks and 29.85 ± 9.95% after 8 weeks of therapy. The reticulocyte count increased while the serum ferritin level decreased during treatment. Thus indicated that Fe was being utilized for promoting the production of erythrocyte in the bone marrow. In 2 cases previously requiring multiple blood transfusions, no further transfusions were needed, thus preventing the dangers of hepatitis, hemosiderosis, or sensitization of HLA histocompatibility antigen. An increase in blood pressure was the side effect detected in 2 cases This was corrected by adding an antihipertensive drug and reducing the r-Hu-Epo dose to the level of the previous week The results of this preliminary trial showed that r-Hu-Epo is a promising drug in restricting multiple blood transfusions and thus the adverse effects caused However, since the drug is relatively expensive, its use is still limited.