This retrospective review assesses the efficacy of
darbepoetin alfa for treating
anemia after
renal transplantation. Patients were evaluated over a 12-week period, and efficacy was based on achieving
hemoglobin >12 g/dL. Thirty-six patients were analyzed (53% male, 53% cadaveric allografts, median age 42.5 years). Baseline
creatinine clearance ranged from approximately 15 to >100 mL/min. Most patients initiated
darbepoetin alfa <3 months (50%) or >12 months (44%) after
transplantation, 19% were previously receiving recombinant human
erythropoietin (rHuEPO), and 47% were on concomitant
ACE inhibitors. The majority of patients received either
tacrolimus- (53%) or
cyclosporine- (44%) based immunosuppression. Overall, 29 (81%) patients achieved the
hemoglobin target with a mean time to response of 4.4 weeks. Neither the time to
anemia onset, previous rHuEPO
therapy, concomitant
ACE inhibitor, allograft source, immunosuppressive regimen, nor degree of renal function affected the proportion of patients achieving the
hemoglobin target, time to response or
darbepoetin alfa dose requirement. Patients with
anemia >12 months post-
transplantation or on concomitant
ACE inhibitors required a significantly longer
duration of therapy. No adverse events associated with
darbepoetin alfa therapy were detected. These results demonstrate that
darbepoetin alfa is a safe and effective treatment for
anemia in renal transplant recipients.