USING OF LONG ACTION ERYTHROPOES STIMULATED AGENTS FOR TREATMENT OF ANEMIA IN PATIENTS WITH CHRONIC KIDNEY DISEASES V D ST

Abstract

the article describes approaches to cost optimization of anemia treatment in CKD–VDst. patients by comparison of costs in phase correction and support treatment with long action ESA in patients on HD and HDF. Aims. To reveal the influence of HD and HDF to summary dozes of ESA in anemia treatment, to reveal the influence of different long action ESA to hemoglobin variability and find connection between HD, HDF and ESA type to cost of ESA using. Materials and methods. There were 14 patients on HD and 14 on HDF. All patients were treated with dialysis 3 time per week, session duration was 4,5–5 hours. eKt/У were 1,39±0,06 in HDF group and 1,29±0,07 in HD group. Mean hemoglobin was 98,3±2,46 g/l in HDF group and 92,76±2,46 g/l in HD group. In correction phase we used pegylated erythropoietin–p in both groups before achievement target hemoglobin 110 g/l, then was support phase ofanemia treatment during 6 months with hemoglobin target 100g/l to 120 g/l. Next 6 months patients were switched to darbepoetin alfa. Results. It is investigated optimization of anemia correction with long action ESP in patients on HD and HDF. It is revealed a tendency to decrease treatment cost with pegylated erythropoietin–p compared to darbepoetin alfa (1965,13±250,69 vs 2117,39±147,59 Gr/mth) and HDF group compared HD group with pegylated erythropoietin–p (1983,9±345,9 vs 1950,69±367,1 Gr/mth). Treatment with darbepoetin alfa associated with higher hemoglobin variability compared with pegylated erythropoietin–p. Conclusion. The result of our investigation lead to prove some hope to optimization of anemia treatment in patients with CKD Vst. On hemodialysis, but to have statistically reliability we need lager patients groups.

Keywords

• anemia, ESA (erythropoes stimulated agents), hemodialysis, hemodiafiltration, pegilated erythropoietin–ß, darbopoietin–а, phase of correction, support phase, chronic kidney diseases (CKD).