Safety and efficacy of erythropoietin in children with chronic renal failure

A prospective randomized study of the use of recombinant human erythropoiet in (rHuEPO) in children with chronic renal disease was conducted to assess dosing requirements and side effects. Forty-four children with chronic rena l failure, aged 4 months to 21 years, were studied. Twenty-five patients we re pre dialysis, 10 on peritoneal dialysis, and 9 on hemodialysis. Patients received either 150 U/kg per week or 450 U/kg per week divided thrice week ly of rHuEPO for 12 weeks or until target hemoglobin (Hb) was attained. Dos e was then adjusted to maintain a normal Hb. Eighty-two percent: of patient s reached target Hb by 7.9+/-5.6 weeks (mean+/-SD); 95% of patients in the high-dose group and 66% in the low-dose group reached target Hb within 12 w eeks. The overall median rHuEPO dose at target Hb was 150 U/kg per week. He modialysis patients tended to require more rHuEPO to maintain a normal Hb ( median 250 U/kg per week). Transfusion requirements and panel-reactive anti body levels decreased during the 12 weeks. Iron deficiency and/or hypertens ion occurred in 30% of children. In conclusion, rHuEPO at 150 U/kg per week is safe and effective in treating anemia in children with chronic renal di sease.