Intraperitoneal erythropoietin in children on peritoneal dialysis: A study of pharmacokinetics and efficacy

Kausz, Annamaria T.; Watkins, Sandra L.; Hansen, Cathy; Godwin, Donald A.; Palmer, R.B.; Brandt, John R.

doi:10.1016/s0272-6386(99)70389-6

Cited by 10 publications

(6 citation statements)

References 24 publications

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“…[ 42 ] and Kausz et al. [ 38 ] demonstrated in small cohorts of 10 and 14 patients, respectively, that intraperitoneal administration could maintain Hb when switched from subcutaneous rHuEPO without a significant dose increase. Administration was via a 50-mL intraperitoneal daytime dwell and Reddingius et al.…”

Section: Resultsmentioning

confidence: 99%

Use of erythropoiesis-stimulating agents in children with chronic kidney disease: a systematic review

Bruce

Schulga

Reynolds

2022

Clinical Kidney Journal

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Background and objectives Erythropoiesis-stimulating agents (ESAs) revolutionised the management of anaemia in chronic kidney disease (CKD) when introduced in the late 1980s. A range of ESA types, preparations and administration modalities now exist, with newer agents requiring less frequent administration. Though systematic reviews and meta-analyses have been published in adults, no systematic review has been conducted investigating ESAs in children. Methods The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) statement for the conduct of systematic reviews was used. All available literature on outcomes relating to ESAs in children with CKD was sought. A search of MEDLINE, CINAHL and EMBASE databases were conducted by two independent reviewers. Inclusion criteria were: published trials in English; children with chronic and end-stage kidney disease; use of any ESA studied against any outcome measure. An assessment of risk of bias was carried out on all included randomised trials using the criteria from the Cochrane handbook for systematic reviews of interventions. Two tables were used for data extraction for randomised and observational studies. Study type, participants, inclusion criteria, case characteristics, follow up duration, ESA type and dosage, interventions and outcomes were extracted by one author. Results Of 965 identified articles, 58 were included covering 54 cohorts. 6 were randomised trials and 48 were observational studies. 38 studies assessed the efficacy of recombinant human erythropoietin (rHuEPO), 11 of darbepoetin (DA), and 3 of continuous erythropoietin receptor activator (CERA), with 6 studies appraising secondary outcome measures exclusively. Recruitment to studies was a consistent challenge. The commonest adverse effect was hypertension, though confounding effects often limited direct correlation. Two large cohort studies demonstrated a higher hazard of death independently associated with high ESA dose. Secondary outcome measures included quality of life measures, growth and nutrition, exercise capacity, injection site pain, cardiovascular function, intelligent quotient (IQ), evoked potentials, and platelet function. Conclusions All ESA preparations and modes of administration were efficacious, with evidence of harm at higher doses. Evidence supports individualising treatments with strong consideration given to alternate treatments in patients who appear resistant to ESA therapy. Further research should focus on randomised trials comparing the efficacy of different preparations, treatment options in apparently ESA resistant cohorts and clarification of meaningful secondary outcomes to consolidate patient-relevant indices.

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Section: Resultsmentioning

confidence: 99%

Use of erythropoiesis-stimulating agents in children with chronic kidney disease: a systematic review

Bruce

Schulga

Reynolds

2022

Clinical Kidney Journal

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“…The main disadvantage of intraperitoneal administration of EPO seems to be the need for higher maintenance doses. However, it was established that the absorption of EPO after intraperitoneal administration is similar to absorption after subcutaneous administration if the EPO is added to a small volume (50 mL) of dialysis fluid (2,5,6).…”

Section: Discussionmentioning

confidence: 99%

“…Renal anemia in pediatric patients treated with chronic peritoneal dialysis can be effectively treated with erythropoietin (EPO) (1)(2)(3). Until now, subcutaneous injection has been the most often used mode of administration (3,4).…”

Section: Long-term Effectiveness Of Intraperitoneal Erythropoietin In Children On Nipd By Administration In Small Bagsmentioning

confidence: 99%

“…Until now, subcutaneous injection has been the most often used mode of administration (3,4). Intraperitoneal administration has proven to be an alternative method of treatment (1,2,5). This application route is preferred because subcutaneous injections may be painful and frightening for the child.…”

Section: Long-term Effectiveness Of Intraperitoneal Erythropoietin In Children On Nipd By Administration In Small Bagsmentioning

confidence: 99%

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Long-Term Effectiveness of Intraperitoneal Erythropoietin in Children on Nipd by Administration in Small Bags

Rusthoven

Kar²,

Monnens³

et al. 2001

Perit Dial Int

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“…[7] Moreover, it is also produced by the brain, liver, uterus, trophoblasts, astrocytes and macrophage of the bone marrow. [8] Apart from erythropoiesis, Epo enhances the activity of stem cells,[9] reverses vasospasm,[10] also used in the treatment of chronic renal failure,[11] protects the brain against ischemic injury[12] and preserves the integrity of the endothelium. [13] It has been reported that pretreatment with Epo produces cardioprotection against I/R-induced injury by JAK/STAT,[14] PI-3K/Akt[15] and PKC[16] signaling pathways.…”

Section: Introductionmentioning

confidence: 99%

Mechanism of cardioprotective effect of erythropoietin-induced preconditioning in rat heart

et al. 2010

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Objective:The cardioprotective potential of human recombinant erythropoietin (alpha) (Epo) against ischemia-reperfusion-induced injury is well known. But, the underlying mechanisms are not well elucidated. The aim of this study was to characterize the mechanism involved in the cardioprotective effect of Epo-induced preconditioning in isolated rat heart.Materials and Methods:The heart was mounted on a Langendorff apparatus. After 10 min of stabilization, four cycles of ischemic preconditioning (IPC) were given followed by 30 min of global ischemia and 120 min of reperfusion. Epo preconditioning was induced by four cycles of 5-min perfusion of K-H solution containing Epo (1.0 U/ml) followed by 5 min perfusion with K-H solution. Myocardial infarct size was estimated macroscopically using the triphenyltetrazolium chloride staining technique. The extent of myocardial injury was measured by release of lactate dehydrogenase and creatine kinase-MB in the coronary effluent.Results:The present study demonstrates that Epo preconditioning was almost as effective as IPC. Administration of Wortmannin (100 nM), a PI-3K inhibitor, or Chelerythrine (1 µM), a protein kinase-C (PKC) inhibitor, or AG490 (5 µM), a JAK-2 inhibitor, significantly attenuated the cardioprotective effects of Epo-induced preconditioning.Conclusion:Our result suggest that the cardioprotective potential of Epo-induced preconditioning in isolated rat heart was due to an interplay of the JAK-2, PI-3K and PKC pathways. Inhibition of any one of the three pathways was sufficient to block the cardioprotective effect of Epo-induced preconditioning in isolated rat heart.

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Intraperitoneal erythropoietin in children on peritoneal dialysis: A study of pharmacokinetics and efficacy

Cited by 10 publications

References 24 publications

Use of erythropoiesis-stimulating agents in children with chronic kidney disease: a systematic review

Use of erythropoiesis-stimulating agents in children with chronic kidney disease: a systematic review

Long-Term Effectiveness of Intraperitoneal Erythropoietin in Children on Nipd by Administration in Small Bags

Mechanism of cardioprotective effect of erythropoietin-induced preconditioning in rat heart

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