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Clinical Pharmacology
CLINICAL PHARMACOLOGY
Chronic Renal Failure Patients Endogenous production of erythropoietin is normally regulated by the level of tissue oxygenation. Hypoxia and anemia generally increase the production of erythropoietin, which in turn stimulates erythropoiesis. Text Continues Below
In normal subjects, plasma erythropoietin levels range from 0.01 to 0.03 Units/ mL and increase up to 100-to 1000-fold during hypoxia or anemia. In contrast, in patients with chronic renal failure (CRF), production of erythropoietin is impaired, and this erythropoietin deficiency is the primary cause of their anemia. Chronic renal failure is the clinical situation in which there is a progressive and usually irreversible decline in kidney function. Such patients may manifest the sequelae of renal dysfunction, including anemia, but do not necessarily require regular dialysis. Patients with end-stage renal disease (ESRD) are those patients with CRF who require regular dialysis or kidney transplantation for survival. EPOGEN (r) has been shown to stimulate erythropoiesis in anemic patients with CRF, including both patients on dialysis and those who do not require regular dialysis. 4-13 The first evidence of a response to the three times weekly (TIW) administration of EPOGEN (r) is an increase in the reticulocyte count within 10 days, followed by increases in the red cell count, hemoglobin, and hematocrit, usually within 2 to 6 weeks. Because of the length of time required for erythropoiesis, several days for erythroid progenitors to mature and be released into the circulation, a clinically significant increase in hematocrit is usually not observed in less than 2 weeks and may require up to 6 weeks in some patients. Once the hematocrit reaches the suggested target range (30% to 36%), that level can be sustained by EPOGEN (r) therapy in the absence of iron deficiency and concurrent illnesses. Page: 1 | 2 | 3 | Next >>
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