Iron and PROCRIT®:
Two key approaches with distinct roles
  • The primary cause of anemia in patients with CKD is insufficient production of erythropoietin by the diseased kidneys1
Evaluation of CKD-related Anemia
  • Calculate glomerular filtration rate to identify patients with CKD and determine CKD stage
  • According to the National Kidney Foundation, evaluate anemia when the hemoglobin (Hb) level is
    <13.5 g/dL in adult males and <12 g/dL in adult females2
Role of Iron
  • If treating with iron, the following goals should be targeted2:
Role of Erythropoietic Therapy
  • Erythropoietic therapy stimulates bone marrow RBC production in patients with insufficient levels of endogenous erythropoietin1
  • Nondialysis patients with symptomatic anemia considered for therapy should have a hemoglobin level of <10 g/dL and the following considerations apply6:
    • – The rate of hemoglobin decline indicates the likelihood of requiring an RBC transfusion and
    • – Reducing the risk of alloimmunization and/or other RBC transfusion-related risks is a goal
Iron Use in Conjunction With PROCRIT®
  • In anemic patients deficient in iron and erythropoietin due to CKD, treatment with both iron and an ESA may be needed3
  • Transferrin saturation should be ≥20% and ferritin should be ≥100 mcg/L6
  • If the Hb level exceeds 10 g/dL, reduce or interrupt the dose of PROCRIT®, and use the lowest dose of PROCRIT® sufficient to reduce the need for RBC transfusions6
Anemia Due to Chronic Kidney Disease
PROCRIT® is indicated for the treatment of anemia due to chronic kidney disease (CKD), including patients on dialysis and not on dialysis to decrease the need for red blood cell (RBC) transfusion.
  • PROCRIT® use has not been shown to improve quality of life, fatigue, or patient well-being.
  • PROCRIT® is not indicated as a substitute for RBC transfusions in patients who require immediate correction of anemia.
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References
  1. National Kidney Foundation. K/DOQI clinical practice guidelines for anemia of chronic kidney disease: update 2000. Am J Kidney Dis. 2001;37(1)(suppl 1):S182-S238.
  2. National Kidney Foundation. K/DOQI clinical practice guidelines and clinical practice recommendations for anemia in chronic kidney disease. Am J Kidney Dis. 2006;47(5) (suppl 3):S1-S145.
  3. Clarkson MR, Brenner BM, eds. Pocket Companion to Brenner and Rector’s The Kidney. 7th ed. Philadelphia, PA: Elsevier Saunders; 2005.
  4. Testa U. Apoptotic mechanisms in the control of erythropoiesis. Leukemia. 2004;18:1176-1199.
  5. Mayo Foundation for Medical Education and Research. Diseases and conditions: anemia. http://mayoclinic.com/health/anemia/DS00321/DSECTION=causes. Accessed September 16, 2012.
  6. PROCRIT® Prescribing Information. Janssen Products, LP.
 
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