Clinical experience of recombinant human erythropoietin in uremic children: Report of three cases

Anemia due to decreased erythropoietin production is one of the major complications in uremic patients. The aim of the study is to evaluate the clinical efficiency and safety of rHuEPO in the treatment of anemia in uremic children receiving regular hemodialysis. Three uremic children, age 8, 12, and 14 year-old, under maintenance hemodialysis with hematocrit (Hct) value lower than 20% were observed for 6 months. rHuEPO 50 u/kg were given intravenously three times a week initially. Hct value of 30% was the target of the therapy. All 3 children responded to the therapy and reached the target Hct value within 11 to 18 weeks. They received no further transfusion after the therapy. The maintenance dose to keep Hct value around 30% is 75 to 120 u/kg/wk. The serum biochemistry examination showed no difference before and after the therapy. The physical endurance, bodyweight and height increased in all children. The left ventricular end-diastolic dimension in echocardiography decreased and the ejection fraction increased after 6 months of the treatment. Serum ferritin concentrations decreased in all children. Mild hypertension developed in one child. Heparin dose was increased when the target Hct value was around 30% in 2 children. We suggested that low dose rHuEPO therapy was safe and effective in uremic children, but close monitoring for the development of hypertension and iron deficiency was mandatory.