CORRECTION OF ANAEMIA WITH ERYTHROPOIETIN IN CKD/ESRD PATIENTS

• Published in: Journal of evolution of medical and dental sciences Vol. 4; no. 12; pp. 1927 - 1935
• Main Authors: Gaikwad, Madhukar, Sinha, Shyamal, Sinha, Rashmi, Gore, Anitha, Bhattacharjee, S, Anjaiah, T, Hannan, Abdul, Patankar, Kunal
• Format: Journal Article
• Language: English
• Published: Akshantala Enterprises Private Limited 09.02.2015
• Subjects: Anemia; Chronic kidney failure; Development and progression; Erythropoietin; Ferritin; Glycosylated hemoglobin
• ISSN: 2278-4748; 2278-4802
• DOI: 10.14260/jemds/2015/280

Chronic kidney disease (CKD) is characterized by gradual and permanent loss of kidney function. One of the most common complications of CKD is Anaemia. (1,3) Anaemia often appears earlier in course of CKD and worsens with disease progression. (1,2) Erythropoietin is a hormone synthesized in the kidney is deficient in the majority of patients of CKD thereby predisposing them for developing anaemia. Erythropoiesis stimulating agents ESAs) first became clinically available in 1989 and has contributed to the advances in the management of CKD related anemia. The present study highlights the correction of anaemia with erythropoietin (Eprex) in population having CKD on MHD and anaemia. Based on GFR CKD is divided into five stages from 1-5. Patients often become anaemic at stage 3 or 4 CKD but anaemia may develop as early as stage 2. And it is present in the majority of patients with stage 5 disease. (2,4) The objective of this study is to evaluate efficacy of administration of 10000.U. Epotin alfa sc for once a week as initiation therapy in patients with anaemia of CKD/ESRD on MHD for 28 weeks of duration of treatment. It is a prospective study done at Central Hospital, South Central Railway, Secunderabad on patients with ESRD or stage 4 on maintenance hemodialysis and receiving subcutaneously EPO (Eprex). Serum feritin and %transferrin saturation are estimated before the initiation of EPO(Eprex) & if the levels are below normal, IV IRON 100 mg is given once weekly and oral elemental Iron 200 to 400 mg to every to normalize the serum ferritin and % transferrin saturation levels. Hemoglobin level estimation has done before and after the initiation of the EPO (Eprex) and once in weekly and four weekly to see the response more than 1gm in four weeks to achieve the target hemoglobin level (11 to 12 grams) in 28 weeks. In the present study target hemoglobin level (11-12g/dl) was achieved in 42 out of 50 patients under consideration (84%) in 28 weeks of duration of treatment and not achieved for 8 amongst 50(16%) patients. Increase in the hemoglobin level of 1/dl is seen in 13(26%),>1 g/dl in 29(58%) and <1 g/dl in 8(16%) patients. KEYWORDS: Anaemia, Erythrpoietin, CKD.