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Intraperitoneal erythropoietin in children on peritoneal dialysis: A study of pharmacokinetics and efficacy

A T Kausz1, S L Watkins, C Hansen

  • 1Division of Nephrology, University of Washington, Children's Hospital, Seattle, WA, USA.

American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
|October 12, 1999
PubMed

Insights

Intraperitoneal recombinant human erythropoietin (rHuEPO) is effective for children on peritoneal dialysis, showing similar bioavailability to subcutaneous dosing. Further research is needed to assess the potential increased risk of peritonitis.

Area of Science:

  • Pediatric Nephrology
  • Pharmacokinetics
  • Renal Replacement Therapy

Background:

  • Children with chronic kidney disease often require erythropoiesis-stimulating agents.
  • Peritoneal dialysis (PD) is a common treatment for pediatric end-stage renal disease.
  • Alternative administration routes for recombinant human erythropoietin (rHuEPO) are explored to improve patient convenience and outcomes.

Purpose of the Study:

  • To evaluate the pharmacokinetics and efficacy of intraperitoneal (IP) rHuEPO in children undergoing chronic peritoneal dialysis.
  • To compare the bioavailability of IP rHuEPO with traditional subcutaneous (SC) administration.
  • To assess the safety and effectiveness of long-term IP rHuEPO therapy in this population.

Main Methods:

  • A single IP dose of rHuEPO was administered to eight children on PD, with serum EPO levels monitored over 24 hours.
  • Nine children received 11-12 weeks of chronic IP rHuEPO therapy.
  • Hematocrit levels and rHuEPO dosages were compared to previous SC treatment, and peritonitis risk was assessed.

Main Results:

  • A mean peak serum erythropoietin (EPO) level of 187 mU/mL was achieved at 12 hours post-IP administration.
  • The relative bioavailability of IP rHuEPO was comparable to SC dosing.
  • Patients maintained normal hematocrit levels with similar rHuEPO dosages, but a trend towards increased peritonitis risk was observed.

Conclusions:

  • Intraperitoneal rHuEPO is an effective treatment for anemic children on continuous cycling peritoneal dialysis.
  • The required rHuEPO dosage for IP administration is not significantly different from SC dosing.
  • The potential for an increased risk of peritonitis with IP rHuEPO warrants further investigation.

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