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Complete switch to darbepoetin in a hemodialysis unit

, : Complete switch to darbepoetin in a hemodialysis unit. Clinical Nephrology 64(1): 55-63

In March 2003, our hemodialysis unit switched all patients from subcutaneous (s.c.) rHuEPO to intravenous (i.v.) darbepoetin. The primary outcome was to assess the efficacy of i.v. darbepoetin to maintain target serum hemoglobin (Hb) compared to s.c. rHuEPO. Secondary outcomes were to evaluate the manufacturer's recommend guidelines for conversion of rHuEPO to darbepoetin, and to assess the cost implications of darbepoetin therapy. This was an 18-month open-label observational study of 95 hemodialysis patients. At the time of the switch to darbepoetin (baseline), data were collected retrospectively for six months and prospectively for 12 months, at three-month intervals. The first six months of darbepoetin therapy was considered a dose titration phase, thus, data were analyzed comparing two six-month periods: (-) six months to baseline (rHuEPO phase) and (+) 6-12 months (darbepoetin phase). Doses were titrated to a target Hb of 120-135 g/l. There was no significant difference in Hb between phases at any time point. Mean Hb ranged from 119.6-121.5 g/l for rHuEPO and 121.9-123.4 g/l for darbepoetin. The median darbepoetin dose remained stable throughout the analysis at 30 microg/week while the median dose of rHuEPO rose from 8,000 U/week at minus six months to 9,000 U/week at baseline. Median 12-month cost savings associated with the administration of darbepoetin were estimated at 212,000 dollars. The recommended darbepoetin dose from the manufacturer's conversion table was deemed too low for baseline rHuEPO doses above 17,000 U/week. A more simplified dose conversion nomogram was created. Darbepoetin was able to maintain similar serum Hb levels compared to rHuEPO at a substantially reduced cost.


PMID: 16047646

Other references

Green, M.; Li, K.I.; Wald, E.R.; Guerra, N.; Byers, C., 1992: Duration of rifampin chemoprophylaxis for contacts of patients infected with Haemophilus influenzae type B. Rifampin is recommended as a prophylactic treatment for intimate contacts of young children who develop invasive infections with Haemophilus influenzae type B (Hib). A 4-day course of rifampin (20 mg/kg of body weight per day, not to exceed 600 mg...

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Gu, L.; Qu, J.; Sun, B.; Yu, X.; Li, H.; Cao, B., 2016: Sustained Viremia and High Viral Load in Respiratory Tract Secretions Are Predictors for Death in Immunocompetent Adults with Adenovirus Pneumonia. The predictors for fatal adenovirus (AdV) pneumonia among immunocompetent adults are unclear. Laboratory-confirmed, hospitalized AdV pneumonia adults were prospectively enrolled in Beijing Chao-Yang hospital from March to June 2013. Clinical data...

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Albright, J.A., 1976: Cervical spine injuries in football. Connecticut Medicine 40(10): 677-679

Hanson Paul E.; Stark James R., 2000: National Water-Quality Assessment Program; activities in Minnesota. Biennial Conference on Water Resources in Minnesota: ges 10. 2000.

Vitvitskaya L.V.; Bikbulatove L.S.; Nikonorov S.I.; Kruglikov R.I.; Pol'gin A.B.; Nezavibat'ko V.N.; Alfeeva L.A.; Andreeva L.A., 1987: Effect of synthetic neuropeptides on the behavior and synthesis of the rna in the brain of the young caspian sturgeon. The effect was evaluated of synthetic ACTH analogs, vasopressin and taftsin on motor activity and the elaboration of avoidance response in Acipenser stellatus, as well as on RNA synthesis in nerve and muscle tissues. It was established that the sy...

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Barashkov, G.A.; Gubar', L.N., 1978: Characteristics and structure of automobile injuries. The characteristics of peculiarities of a car trauma in 788 cases is presented. A multiple and combined character of injuries with a severe clinical picture (72.4%) is emphasized. The attention is drawn to leading and frequent severe sequelae of t...