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.
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References
Волгина Г.В. Факторы риска кардиоваскулярных заболеваний у больных с хронической почечной недостаточностью / Волгина Г.В., Перепеченных Ю.В., Бикбов Б.Т. // Нефрология и диализ. – 2000. – Том.2. – №.4. – С.252–259.
Концентрации гемоглобина для диагностики анемии и оценки ее тяжести [Електронний ресурс] / ВООЗ. – 2011. – Режим доступу: http://www.who.int/vmnis/indicators/haemoglobin_ru.pdf
Куликов А.Ю, Аринина Е. Е. Анализ минимизации затрат на терапию нефрогенной анемии эритропо– эзстимулирующими средствами у пациентов с хронической болезнью почек, не получающих диализ // Фармакоэкономика. – 2009. – том.2. – №4. – C.34–37.
Милованова Л.Ю. Прогностическое значение ранней коррекции анемии у больных хронической почечной недостаточностью / Милованова Л.Ю., Николаев
A. Ю., Козлова Т.А. // Нефрол. и диал. – 2004. – №1. – С.54–57.
Національний реєстр хворих на хронічну хворобу нирок 2013 рік // Академія медичних наук України, Міністерство охорони здоров’я України, Державна установа «Інститут нефрології АМН України»; укладачі Н.І. Козлюк, Г.С. Владзієвська, М.В. Кулизький; гол.ред. М.О. Колесник. – К., Поліграфплюс, 2013. – 200с. – 40 прим.
Рыбакова О.Б. Эффективность гемодиализа и гемодиафильтрации ОП+ІПЄ в лечении анемии у больных с терминальной ХПН / О.Б. Рыбакова, А.Ю. Денисов, B. Ю. // Нефрология. – 2003. – Т. 7, приложение 1
Annual Data Report: Atlas of End–Stage Renal Disease in the United States. (Electronic resource) // US Renal Data System, USRDS 2006. Bethesda, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases. – 2006. – Mode of access: http://www.usrds.org/atlas09.aspx
Bonforte G. Improvement of anemia in hemodialysis patients treated by hemodiafiltration with high–volume online–prepared substitution fluid / Bonforte G., Grillo P., Zerbi S., Surian M. // Blood Purif. – 2002. – Vol.20. – №4. – P.357–63.
F.Carrera, M.Burnier Use of darbepoetin alfa in the treatment of anaemia of chronic kidney disease: clinical and pharmacoeconomic consideration // NDT Plus. – 2009. – Vol.2. – Suppl.1. – P. 9–17.
B. Cianciaruso Effect of high–flux hemodialysis on anemia correction of esrd patients. Sample size assessment for a randomized controlled trial (rct) / B.Cianciaruso, A. Di Benedetto, B. Memoli, G. Buccino, R. Di Donato, G. Pacchiano, R. Iandolo, M. Palma Iavarone, E. De Felice, G. Policastro, M. Buccino, M. Ventre, D. Marcelli, V. E. Andreucci // World Congres of Nephrology 2003 W454.
E.De Cock Time savings associated with C.E.R.A. oncemonthly: a time–and–motion study in hemodialysis centers in five European countries / E.De Cock, F. Dellanna, K. Khellaf, W. Klatko, F. Maduell, M. Raluy– Callado, G. Villa // Journal of Medical Economics. – 2013. – Vol.16. – No. 5. – P.648–656.
Cody J, Daly C, CampbellM, etal. Recombinant human erythropoieetin for chronic renal failure anemia in predialysis patients (Cochrane Review). In: The Cochrane Library. Issue 3, 2003. Update Software, Oxford.
Collins A.J. Anaemia management prior to dialysis: cardiovascular and cost–benefit observations // Nephrology Dialysis Transplantation. – 2003. – №18. – Suppl 2. – P. 2–6
J. P. Ebben Hemoglobin level variability: associations with comorbidity, intercurrent events, and hospitalizations. / J. P. Ebben, D. T. Gibertson, R. N. Foley [et al.] // Clin. J. Am. Soc. Nephrol. – 2006. – Vol. 1, № 6. – Р. 12051210.
European Best Practice Guidelines for Haemodialysis (Part 1) // Nephrol. Dial. Transplant. – 2002. – Vol.17. – Suppl.7. – P.45–46
M. Garozzo Hyperhomocysteinemia and the adeqecy of standart hemodialysis and ON–LINE hemodiafiltration / M. Garozzo, S.Urso, F.Milone, G.Battaglia // World Congres of Nephrology 2003 W 476.
Gouva C. Treating anemia early in renal failure patients slows the decline of renal function: A randomized controlled trial / Gouva C., Nicolopoulos P., Ioannidis J., Siamopoulous K. C. // Kidney International. – 2004. – Vol.66. – P. 753–760.
HsuP.Y. Ultrapure dialysate improves iron utilization and erythropoietin response in chronic hemodialysis patients - a prospective cross–over study / Hsu P.Y., Lin C.L., Yu
C. C., Chien C.C., Hsiau T.G., Sun T.H., Huang L.M., Yang C.W. // J Nephrol. – 2004. – Vol.17. – P.693–700.
Hue J.L. Anemia treatment in the pre–ESRD period and associated mortality in elderly patients / J.L. Hue, W.R.St Peter, J.P. Ebben [et al.] // Am. J. Kidney Dis. – 2002. – Vol.40. – P. 1153–1161.
Jones M. Impact of epoetin alfa on clinical end points in patients with chronic renal failure: A meta–analysis / Jones M., Ibels L., Schenkel B., Zagari M. // Kidney International. – 2004. – Vol.65. – P. 757–767.
Kalantar–Zadeh К. Hemoglobin Variability in Anemia of Chronic Kidney Disease / K. Kalantar–Zadeh and G. R. Aronoff // J. Am. Soc. Nephrol. – 2009. – Vol. 20. – P. 479–487.
Kimel M. Does Epoetin Alfa Improve Health–Related Quality of Life in Chronically Ill Patients with Anemia? Summary of Trials of Cancer, HIV/AIDS, and Chronic Kidney Disease / Kimel M., Leidy K., Mannix S., Dixon J. // Value In Health. – 2008. – Vol.11. – №1. – P. 57–75.
Klinger M. Efficacy of intravenous methoxy polyethylene glycol–epoetin beta administered every 2 weeks compared with epoetin administered 3 times weekly in patients treated by hemodialysis or peritoneal dialysis: a randomized trial / Klinger M., Arias M., Vargemezis V., Besarab A. // Am J Kidney Dis. – 2007. – Vol.50. – P.989–1000.
LedeboI., NystrandR. Defining the microbiological quality of dialysis fluid // Artif Organs. – 1999. – Vol.23. – P.37–43.
Locatelli F.L. The modality of dialysis treatment: does it influence the response to erythropoietin treatment / Locatelli F.L., del Vecchio // Nephrol Dial Transplant. – 2001. – Vol.16. – P.1971–1974.
Macdougall I. C.E.R.A. corrects anaemia in patients with chronic kidney disease not on dialysis: results of a randomized clinical trial / Macdougall I., Walker R., Provenzano R. // Clin. Am. Soc. Nephrol. – 2008. – Vol.3. – P.337–347.
Moyneur E, Bookhart B, Mody S, Fournier A., Mallet D, Duh M.S. // Poster presented on the American Occupational Health Conference (AOHC). – 2006. Los Angeles, CA
NKF–K/DOQI Clinical Practice Guidelines for Anemia of Chronic Kidney Disease: update 2000 / Am. J. Kidney Dis. – 2001. – Vol.37. – Suppl. 1. – S.182–238.
J.J.P rez–Ruixo Between subjects variability in haemoglobin and dose are not associated with the erythropoi– esis–stimulating agent used to treat anaemia in dialysis: a meta–analysis / Juan José Pérez–Ruixo, Mercedes Cucala–Ramos, Ester Garcia–Gonzalo, Beatriz Del Val Romero, Valveny N. //Br J Clin Pharmacol. – 2013. – Vol.75. – P.15–25
D. Richardson Clinical factors influencing sensitivity and response to epoetin // Nephrol Dial Transplant. – 2002. – Vol.17. – Suppl.1. – P.53–59.
B. Schiller Costs of managing anemia with erythropoi– esis–stimulating agents during hemodialysis: A time and motion study / B.Schiller, S.Doss, E.DE Cock, M.A. DEL Aguila, A. R. Nissenson // Hemodialysis International. – 2008. – Vol.12. – P.441–449.
H. Schmid Cost–effectiveness of continuous erythropoietin receptor activator in anemia Dove Press journal http://dx.doi.org/10.2147/CEOR.S46930.
SilverbergD. Outcomes of anaemia management in renal insufficiency and cardiac disease // Nephrology Dialysis Transplantation. – 2003. – №18. – Suppl 2. – P.7–12
SikandH. Cost analytic model to determine the least costly inpatient erythropoiesis stimulating therapy regimen / Sikand H., Decter A., Greco T. // Ann. Pharmacother. – 2008. – Vol.42. – P.16–23.
Sitter T. Dialysate related cytokine induction and response to recombinant human erythropoietin in haemodialysis patients / Sitter T., Bergner A, Schiffl H. // Nephrol Dial Transplant. – 2000. – Vol.15. – P.1207– 1211.
B. V. Stefansson. Haraldsson Hemodiafiltration Improves Plasma 25–Hepcidin Levels: A Prospective, Randomized, Blinded, Cross–Over Study Comparing Hemodialysis and Hemodiafiltration / B. V. Stef nsson, M.Abramson, U.Nilsson, B. Haraldsson // Nephron Extra 2012. – Vol.2. – P. 55–65.
Stevens P. Optimizing renal anaemia management – benefits of early referral and treatment // Nephrology Dialysis Transplantation. – 2005. – №20. – Suppl 8. – P.22–26.
Sulowicz W. Once–monthly subcutaneous CERA maintains stable hemoglobin control in patients with chronic kidney disease on dialysis and converted from epoetin one to three times weekly / Sulowicz W., Locatelli F., Ryckelynck J. // Clin. J.Am. Soc. Nephrol. – 2007. – Vol. 2. – P.637–646.
Vaslaki L. On–line haemodiafiltration versus haemodialysis: stable haematocrit with less erythropoietin and improvement of other relevant blood parameters / Vaslaki L., Major L., Berta K., Karatson A., Misz M. // Blood Purif. – 2006. – Vol.24. – №2. – P.163–173
Ward R.A. A comparison of on–line hemodiafiltration and high–flux hemodialysis: a prospective clinical study / Ward R.A., Schmidt B., Hullin J. // J Am Soc Nephrol. – 2000. – Vol.11. – P.2344–2350.
Weiss G. Anemia of Chronic Disease/ Weiss G., Goodnough L.T // N. Engl. J. Med. – 2005. – Vol.352. – P.1011–23.
Wizemann V., Lotz C., Techert F. On–line haemodiafiltration versus low–flux haemodialysis. A prospective randomized study / Wizemann V., Lotz C., Techert F. // Nephrol Dial Transplant. – 2000. – Vol.15. – Suppl.1. – P.43–48.
W. Yang Hemoglobin variability and mortality in ESRD. / W. Yang, R. K. Israni, S. M. Brunelli // J. Am. Soc. Nephrol. – 2007. – Vol. 18, № 12. – Р. 3164–3170.















