Comparative Effects of Pegylated Erythropoietin and Darbepoetin Alfa on Erythropoietin Hyporesponsive Anemia of Patients with Chronic Kidney Disease on Maintenance Hemodialysis

Objectives This study was carried out to evaluate the effect of pegylated erythropoietin and to compare its effects with the effects of darbepoetin alfa on anemia of chronic kidney patients on maintenance hemodialysis having erythropoietin hyporesponsiveness. Methods Forty adult patients of chronic kidney disease(CKD) with erythropoietin hyporesponsiveness undergoing maintenance hemodialysis were included in the study. These patients were randomly divided into two groups, Group A consisting of 20 patients who received Subcutaneous Pegylated erythropoietin at a dose of 0.6 mcg/kg body weight, once in every two weeks along with intravenous iron 100 mg/week for 3 months. Group B patients received subcutaneous darbepoietin alfa at a dose of 0.45 mcg/kg body weight once weekly along with iv iron 100mg /week for 3 months. Hematological, renal and inflammatory parameters such as erythrocyte sedimentation rate, C reactive protein, serum ferritin and transferrin saturation were measured at monthly intervals for three months, compiled and analyzed statistically. Results At the end of the study, in group A there was a significant rise in the hemoglobin, haematocrit and transferrin saturation (p l 0.001 for each of them) while there was a significant decrease in serum ferritin levels (pl0.001). In group B0.05), and also there was a significant rise in the serum ferritin levels at the end of the study (pl 0.05). The mean rise in hemoglobin between subsequent months was higher in group A as compared to group B which was statistically significant. Conclusion Pegylated erythropoietin is better than darbepoetin alfa in overcoming erythropoietin hyporesponsiveness and maintaining stable hemoglobin levels in CKD patients on maintenance hemodialysis.