Open AccessThe Use of Darbepoetin to Stimulate Erythropoiesis in the Treatment of Anemia of Chronic Kidney Disease in Dogs
Author(s) -
Fiocchi E.H.,
Cowgill L.D.,
Brown D.C.,
Markovich J.E.,
Tucker S.,
Labato M.A.,
Callan M.B.
Publication year - 2017
Publication title -
journal of veterinary internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.356
H-Index - 103
eISSN - 1939-1676
pISSN - 0891-6640
DOI - 10.1111/jvim.14681
Subject(s) - medicine , darbepoetin alfa , anemia , adverse effect , kidney disease , dosing , erythropoiesis , pure red cell aplasia , vomiting , erythropoietin , gastroenterology
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%).