Volume : 10, Issue : 05, May – 2023
Title:
21.DRUG UTILIZATION AND EVALUATION OF ERYTHROPOIETIN STIMULATING AGENTS IN HAEMODIALYSIS PATIENTS IN A TERTIARY CARE HOSPITAL
Authors :
Siddiqua Parveen,Ameena Begum,Sarah Hussain,Syeda Shiza Aleem, Dr. Anupama Koneru
Abstract :
Introduction: Anemia is most commonly associated with chronic kidney disease. In CKD patients, anemia usually occurs due to a decrease in the production of erythropoietin hormone by the kidneys. FDA has approved erythropoietin stimulating agents for the treatment of anemia. The main aim is to study drug utilization and evaluation of erythropoietin stimulating agents in hemodialysis patients.
Objectives:To study hemodialysis patients with various comorbidities for effective drug utilization.To evaluate possible drug interactions, adverse reactions, and therapeutic outcomes of erythropoietin stimulating agents in hemodialysis. To evaluate the therapeutic use of antihypertensive in various hemodialysis patients
Methodology: It was a prospective, observational study in the department of nephrology carried out on 110 patients for 6 months. The study was conducted in the Aster Prime hospital, Hyderabad. The data were collected through patient interaction, inpatient case sheets, and lab reports of enrolled patients in the study. Statistical analysis was reported using descriptive statistics, paired t-tests, and ANOVA.
Results: We evaluated the effectiveness of erythropoietin stimulating agents by measuring lab parameters like hemoglobin, hematocrit, iron and RBC over a period of 3 months and our results show a significant increase in hemoglobin levels from month 1 (Mean=8.75, Standard deviation=1.37) to month 2 (Mean=9.22, Standard deviation= 1.47) to month 3 (Mean=9.70, Standard deviation=1.50), a significant increase in hematocrit levels from month 1 (Mean=39.71, Standard deviation=2.06) to month 2 (Mean=39.74, Standard deviation=2.16) to month 3 (Mean=40.62, Standard deviation=2.19), a significant increase in iron levels from month 1 (Mean=130.74, Standard deviation=33.32) to month 2 (Mean=135.62, Standard deviation=33.06) to month 3 (Mean=138.49, Standard deviation=32.79), show a significant increase in RBC levels from month 1 (Mean=3.37, Standard deviation=0.44) to month 2 (Mean=3.54, Standard deviation=0.37) to month 3 (Mean=3.73, Standard deviation=0.44).
Conclusion: In our study by using ANOVA, we found out that in the lab parameters such as hemoglobin, hematocrit, iron, and RBC levels there is a significant difference over some time and the values of these parameters were increased over time by the use of ESA.
Based on the above findings, we can conclude that erythropoietin stimulating agents help improve anemia in CKD patients undergoing hemodialysis.
Keywords: Chronic kidney disease (CKD), hemodialysis, erythropoietin stimulating agents, anemia, blood pressure
Cite This Article:
Please cite this article in press Anupama Koneru et al, Drug Utilization And Evaluation Of Erythropoietin Stimulating Agents In Haemodialysis Patients In A Tertiary Care Hospital, Indo Am. J. P. Sci, 2023; 10 (05).
Number of Downloads : 10
References:
1.Pharmacotherapy: A Pathophysiologic Approach,9e: Joseph T.Dipiro, Robert L,albert, Gary C.Yee, Gary R.Matzke, Barbara G Wells, L.Michael Posey, Section 4, Chapter 29.
2. Textbook of Pathology: Harsh Mohan Edition-Chapter22 Pg.653
3.https://www.pdempowers.com/patientwhat-ckd-and-how-it-treatedckd-treatment-options/what-dialysis
4.https://www.sciencedirect.com/topics/medicine-and-dentistry/dialysis fluid#:~:text=Dialysate%20solution%20commonly%20contains%20six,invariably%20present%20in%20the%20dialysate.
5. https://www.azuravascularcare.com/infodialysisaccess/types-of-dialysis-access/
6.https://www.vascularhealthclinics.org/institutes-divisions/vascular-surgery-and-medicine/dialysis-access/
7. https://www.kidney.org/contents/understanding-pros-and-cons-hemodialysis
8. Jelkmann W. Erythropoietin. Front Horm Res. 2016; 47:115-27. [PubMed]
9.Noxon V, Knopf KB, Norris LB, Chen B, Yang YT, Qureshi ZP, Hrushesky W, Lebby AA, Schooley B, Hikmet N, Dickson M, Thamer M, Cotter D, Yarnold PR, Bennett CL. Tale of Two Erythropoiesis-Stimulating Agents: Utilization, Dosing, Litigation, and Costs of Darbepoetin and Epoetin Among South Carolina Medicaid-Covered Patients With Cancer and Chemotherapy-Induced Anemia. J OncolPract. 2017 Jun; 13(6):e562-e573. [PMC free article] [PubMed]
10. Miyake T, Kung C, Goldwasser E: Purification of human erythropoietin. J BiolChem 1977; 252:5558-5563.
11. Lin FK, Suggs S, Lin CH, et al: Cloning and expression of the human erythropoietin gene. ProcNatlAcadSci U S A 1985; 82:7580-7584.
12. US Congress – Office of Technology Assessment. Recombinant Erythropoietin: Payment Options for Medicare, OTA-H-451. 1990. https://www.princeton.edu/∼ota/disk2/1990/9038/9038.PDF.
13. Jelkmann W. Physiology and pharmacology of erythropoietin. Transfus Med Hemother. 2013 Oct;40(5):302-9. [PMC free article] [PubMed]
14.Glaspy JA, Charu V, Luo D, Moyo V, Kamin M, Wilhelm FE. Initiation of epoetin-alpha therapy at a starting dose of 120,000 units once every 3 weeks in patients with cancer receiving chemotherapy: an open-label, multicenter study with randomized and nonrandomized treatment arms. Cancer. 2009 Mar 01; 115(5):1121-31. [PubMed]
15.McCullough PA, Barnhart HX, Inrig JK, Reddan D, Sapp S, Patel UD, Singh AK, Szczech LA, Califf RM. Cardiovascular toxicity of epoetin-alfa in patients with chronic kidney disease. Am J Nephrol. 2013; 37(6):549-58. [PubMed]
16. Malliara M. The management of hypertension in haemodialysis and CAPD patients. Hippokratia. 2007; 11(4):171-174.
17. Schoener B, Borger J. Erythropoietin Stimulating Agents. [Updated 2022 Feb 5]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK536997/
18.Pavlovic, D1; Heinrich, B2; Jakic, M3; Bogadi, I4; Petric, P5; Germin-Petrovic, D6; Mihaljevic, D3; Coric-Martinovic, V7; Dits, S8; Kudumija, B8; Iskra, B9; Lovcic, V10; Vujic, J10; Ivankovic, Z11; Ladavac, R12; Pavlovic, N1; Cala, K1 ANTIHYPERTENSIVE DRUG THERAPY IN HAEMODIALYSIS PATIENTS: PP.33.319, Journal of Hypertension: June 2010 – Volume 28 – Issue – p e545-e546 doi: 10.1097/01.hjh.0000379857.21921.27