Interchanging Darbepoetin Alfa and Epoetin Alfa in Treatment of Anemia in Pediatric Patients on Regular Hemodialysis: It is possible.

Said, Ragia Marei; El Hakim, Ihab Zaki; Ibrahim, Nada Essam; Affifi, Maged Elsayed

doi:10.21608/geget.2024.406502

Interchanging Darbepoetin Alfa and Epoetin Alfa in Treatment of Anemia in Pediatric Patients on Regular Hemodialysis: It is possible.

Document Type : Original Article

Authors

¹ Department of Pediatrics and Pediatric Nephrology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

² Faculty of Medicine, Ain Shams University, Cairo, Egypt.

10.21608/geget.2024.406502

Abstract

Introduction: Anemia frequently occurs as a comorbidity in chronic kidney disease (CKD). In the management of anemia among patients undergoing hemodialysis, erythropoiesis-stimulating agents (ESAs) play a crucial role.
Aim of the Study: we aimed to explore the feasibility of using darbepoetin and epoetin alfa interchangeably with the same patient and to assess the differences in side effects associated with each ESA.
Methods: A crossover study was conducted at the Pediatric Dialysis Unit of Ain Shams University Children’s Hospital, involving forty patients diagnosed with end-stage kidney disease (ESKD) who were receiving regular hemodialysis over an eight-month period. Patients with known blood disorders causing anemia, active blood loss, infections, uncontrolled hypertension, or serious allergic reactions to ESAs were excluded. The participants were randomly assigned into two equal groups. Each group was given one type of ESA for three months before switching to the other type for an additional three months. Blood samples were collected at both the beginning and end of each three-month treatment phase to measure hemoglobin levels, serum urea, serum creatinine, and iron profile indicators.
Results: The analysis revealed no significant differences in hemoglobin levels between the two drugs. The switch from one ESA to another did not result in any notable drop in hemoglobin levels. Additionally, no serious adverse effects such as convulsions, hypertension, or thrombosis were observed with either medication.
Conclusion: The findings suggest that it is feasible to interchange between darbepoetin and epoetin alfa in pediatric patients undergoing hemodialysis without compromising Hb level or risking grave side effects.

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