The Use of Darbepoetin to Stimulate Erythropoiesis in the Treatment of Anemia of Chronic Kidney Disease in Dogs

E. H. Fiocchi, Larry D Cowgill, D. C. Brown, J. E. Markovich, S. Tucker, M. A. Labato, M. B. Callan

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: Darbepoetin alfa (darbepoetin) is an erythropoiesis-stimulating agent used for the treatment of anemia secondary to chronic kidney disease (CKD) in dogs, but reports describing response are lacking. Hypothesis/Objectives: To evaluate the effectiveness of darbepoetin in dogs with anemia secondary to CKD, dosing protocols, and adverse events. Animals: Thirty-three client-owned dogs with naturally occurring CKD, including 26 with comorbidities. Methods: Multi-institutional retrospective study. Results: The median starting dosage and highest dosage of darbepoetin administered were 0.5 and 0.8 μg/kg SC once weekly, respectively. Response to treatment was defined as achieving a packed cell volume (PCV) ≥30% or an increase in PCV ≥10%. Twenty-eight of 33 dogs (85%) achieved a PCV ≥30% and 22 of 33 (67%) dogs achieved an increase in PCV ≥10%. Median time to achieve a PCV ≥30% was 29 days. A higher starting dosage was associated with achieving an increase in PCV ≥10% (P =.01). No dog sustained a response at a dosing interval >q21d. Potential adverse events included increased blood pressure requiring treatment (n = 12), seizures (n = 5), vomiting (n = 3), diarrhea (n = 3), and possible pure red cell aplasia (PRCA) (n = 2). Conclusions and Clinical Importance: Darbepoetin, when combined with treatment of comorbidities, is an effective treatment for anemia secondary to CKD in dogs. A dosing interval >q21d was ineffective at maintaining a response to treatment. PRCA was a possible adverse event in 2 of 33 dogs (6%).

Original languageEnglish (US)
Pages (from-to)476-485
Number of pages10
JournalJournal of Veterinary Internal Medicine
Volume31
Issue number2
DOIs
StatePublished - Mar 1 2017

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erythropoiesis
Erythropoiesis
kidney diseases
Chronic Renal Insufficiency
Anemia
Cell Size
Dogs
hematocrit
dogs
Pure Red-Cell Aplasia
anemia
Comorbidity
Hematinics
pressure treatment
administered dose
vomiting
seizures
dosage
retrospective studies
Vomiting

Keywords

  • Erythropoietin
  • Iron
  • Pure red cell aplasia
  • Renal disease

ASJC Scopus subject areas

  • veterinary(all)

Cite this

The Use of Darbepoetin to Stimulate Erythropoiesis in the Treatment of Anemia of Chronic Kidney Disease in Dogs. / Fiocchi, E. H.; Cowgill, Larry D; Brown, D. C.; Markovich, J. E.; Tucker, S.; Labato, M. A.; Callan, M. B.

In: Journal of Veterinary Internal Medicine, Vol. 31, No. 2, 01.03.2017, p. 476-485.

Research output: Contribution to journalArticle

Fiocchi, E. H. ; Cowgill, Larry D ; Brown, D. C. ; Markovich, J. E. ; Tucker, S. ; Labato, M. A. ; Callan, M. B. / The Use of Darbepoetin to Stimulate Erythropoiesis in the Treatment of Anemia of Chronic Kidney Disease in Dogs. In: Journal of Veterinary Internal Medicine. 2017 ; Vol. 31, No. 2. pp. 476-485.
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abstract = "Background: Darbepoetin alfa (darbepoetin) is an erythropoiesis-stimulating agent used for the treatment of anemia secondary to chronic kidney disease (CKD) in dogs, but reports describing response are lacking. Hypothesis/Objectives: To evaluate the effectiveness of darbepoetin in dogs with anemia secondary to CKD, dosing protocols, and adverse events. Animals: Thirty-three client-owned dogs with naturally occurring CKD, including 26 with comorbidities. Methods: Multi-institutional retrospective study. Results: The median starting dosage and highest dosage of darbepoetin administered were 0.5 and 0.8 μg/kg SC once weekly, respectively. Response to treatment was defined as achieving a packed cell volume (PCV) ≥30{\%} or an increase in PCV ≥10{\%}. Twenty-eight of 33 dogs (85{\%}) achieved a PCV ≥30{\%} and 22 of 33 (67{\%}) dogs achieved an increase in PCV ≥10{\%}. Median time to achieve a PCV ≥30{\%} was 29 days. A higher starting dosage was associated with achieving an increase in PCV ≥10{\%} (P =.01). No dog sustained a response at a dosing interval >q21d. Potential adverse events included increased blood pressure requiring treatment (n = 12), seizures (n = 5), vomiting (n = 3), diarrhea (n = 3), and possible pure red cell aplasia (PRCA) (n = 2). Conclusions and Clinical Importance: Darbepoetin, when combined with treatment of comorbidities, is an effective treatment for anemia secondary to CKD in dogs. A dosing interval >q21d was ineffective at maintaining a response to treatment. PRCA was a possible adverse event in 2 of 33 dogs (6{\%}).",
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