Hospital of Saint Raphael, Metabolism Associates, Yale University, New Haven, Connecticut, USA.
Clin Drug Investig. 2011;31(2):113-20. doi: 10.1007/BF03256938.
The management of anaemia in chronic kidney disease (CKD) to achieve current guideline goals is difficult and is hindered by multiple factors, including problems with the scheduling and adjustment of dosing of erythropoiesis-stimulating agents (ESAs) and the frequency of required ESA administration to achieve target haemoglobin (Hgb) levels.
The primary objective of this study was to examine whether converting a large cohort of CKD patients receiving epoetin alfa to darbepoetin alfa would decrease the frequency of drug administration while permitting an acceptable management of CKD-related anaemia.
In this retrospective cohort study of practice in a community-based CKD anaemia clinic, we evaluated the effects of conversion of a baseline group of 283 patients from epoetin alfa to darbepoetin alfa with a goal of decreasing the frequency of ESA administration while maintaining Hgb levels within a target range. The study observation period extended for 15 months after the initial conversion. An additional 256 CKD patients were started on darbepoetin alfa during the observation period and the frequency of their injections and the range of their Hgb levels were also monitored.
Following the conversion to darbepoetin alfa, we were able to increase the number of patients on once-monthly injections from 21% to 76% while keeping Hgb levels in the target range and maintaining stable blood pressure control. The mean number of ESA injections/patient/month decreased from 2.1 to 1.3.
In a community-based CKD anaemia clinic, conversion from epoetin alfa to darbepoetin alfa resulted in a decreased frequency of injections needed to maintain Hgb levels within an accepted target range.
慢性肾脏病（CKD）患者贫血的管理难以达到现行指南目标，这受到多种因素的阻碍，包括促红细胞生成素刺激剂（ESA）的给药时间和剂量调整以及达到目标血红蛋白（Hgb）水平所需的 ESA 给药频率方面存在问题。
本研究的主要目的是检验将接受促红素治疗的大量 CKD 患者转换为达贝泊汀是否会减少给药频率，同时允许对 CKD 相关贫血进行可接受的管理。
本研究是对一个基于社区的 CKD 贫血诊所的实践进行的回顾性队列研究，我们评估了将基线组 283 例患者从促红素转换为达贝泊汀的效果，目标是在维持 Hgb 水平在目标范围内的同时减少 ESA 给药频率。研究观察期在最初转换后的 15 个月内延长。在观察期间，还有 256 例 CKD 患者开始接受达贝泊汀治疗，也监测了他们的注射频率和 Hgb 水平范围。
转换到达贝泊汀后，我们能够将每月接受一次注射的患者比例从 21%增加到 76%，同时保持 Hgb 水平在目标范围内，并保持稳定的血压控制。患者每月 ESA 注射次数从 2.1 次减少到 1.3 次。
在基于社区的 CKD 贫血诊所中，从促红素转换到达贝泊汀可减少维持 Hgb 水平在可接受目标范围内所需的注射频率。
