DARBEPOIETIN ALPHA IN TREATMENT OF ANEMIA OF CKD — AN INDIAN
EXPERIENCE
Dr Prashant Rajput, Dr Bharat Shah—Narmada Kidney Foundation & Anil Clinic, Mumbai
AIM: Darbepoietin is a new ESA with a longer half life. We studied the efficacy and safety of
darbepoietin (Cresp, Dr. Reddy’s laboratory) in Indian patients with chronic kidney disease (CKD).
METHODS: We included 50 patients with chronic kidney disease having Hemoglobin concentrations
less than 10 gm/dl. For inclusion, all patients had to have adequate iron status (transferring saturation >
20%).Patients with active infection & malignancy were excluded. Darbepoietin was administered in a
dose 0.45 mcgm/kg subcutaneously once a week or once in 2 weeks. The dose of darbepoietin was
adjusted as per the response (25% increase if inadequate response and 25% decrease if more than
adequate response).
RESULTS: The mean age was 54.26±13.3. There were 30 (60%) males and 20 (40%) females. The mean
(SD) hemoglobin at baseline was 7.9 (0.8) g/dl. This increased to 8.4 (0.9) g/dl at 1 month, 10 (0.97) g/dl
at 3 months and 11.1 g/dl (1.0) at 6 months. Three patients had worsening of hypertension, 2 patients had
hyperkalemia and 2 had cardiovascular events. The average cost of treatment was Rs 3300/- per month.
There was no significant difference in response in diabetic and non diabetic subjects and in pre dialysis &
dialysis patients.
CONCLUSIONS: Darbepoietin alpha is effective in treatment of anemia of CKD with adverse events
similar to other ESA .It is cost effective and allows reduced dosing frequency.