• History of Erythropoietic Protein Therapy
• How Do Erythropoietic Proteins Work?
• What Benefits Are Associated With Treatment of Anemia?
• During Treatment With Erythropoietic Proteins What Should My Target Hemoglobin Level Be?
• Side Effects of Erythropoietic Protein Therapy

In 1983, scientists at Amgen Inc. first identified the gene responsible for making erythropoietin in humans. Through the use of biotechnology, this discovery allowed scientists to produce sufficient quantities of recombinant human erythropoietin (rHuEPO) to begin clinical trials. From these early studies, erythropoietic protein therapy was developed for use as a highly effective treatment for anemia of chronic kidney disease.²

Erythropoietic proteins are now widely used for managing the anemia of chronic kidney disease.²

How Do Erythropoietic Proteins Work?

Erythropoietin is a naturally occurring hormone made primarily by the kidneys. It acts on the bone marrow to produce red blood cells, which are necessary to supply oxygen throughout the body.²

Erythropoietic proteins used to treat anemia of chronic kidney disease stimulate erythropoiesis by exactly the same mechanism as the naturally-occurring erythropoietin.¹⁷ They bind to special cells in the bone marrow, which eventually produce mature red blood cells.

What Benefits Are Associated With Treatment of Anemia?

Appropriate treatment of anemia of chronic kidney disease may offer many patients an improved quality of life, increased exercise capacity, better cognitive function (i.e. thinking, perception, ability to reason), and reductions in certain types of cardiac disease.

Clinical studies have confirmed that patients with chronic kidney disease (CKD) benefit from even a partial correction of their anemia.¹⁸

During Treatment With Erythropoietic Proteins What Should My Target Hemoglobin Level Be?

For patients receiving erythropoietic protein to help manage anemia, hemoglobin levels must be monitored regularly.

Significant clinical benefits associated with treating anemia of chronic kidney disease are usually evident when hemoglobin levels are elevated to greater than 100 g/L.⁹

The Clinical Practice Guidelines of the Canadian Society of Nephrology (CSN) for Treatment of Patients with Chronic Renal Failure suggest that patients' hemoglobin levels should not fall below 100 g/L or rise above 130 g/L.

The CSN suggests that if 110-120 g/L is used as a target hemoglobin, a majority of CRF patients will attain this goal.⁹

Side Effects of Erythropoietic Protein Therapy

In clinical trials, many of the reported side effects are symptoms that are frequently seen in patients with chronic kidney disease, or are common complications of dialysis. Some of the side effects potentially associated with erythropoietic protein therapy are listed below.¹