Pharmacokinetics of recombinant human erythropoietin in children treated with continuous ambulatory peritoneal dialysis.

Unlabelled: In children treated by continuous ambulatory peritoneal dialysis (CAPD) renal anaemia is preferably treated by intraperitoneal administration of erythropoietin, since subcutaneous administration is painful and frightening for the child. Pharmacokinetics of erythropoietin were studied in three groups of children treated by CAPD. In group subcutaneous (SC) (n = 5) erythropoietin was administered subcutaneously, whereas in group intraperitoneal 1 (IP1) (n = 8) and intraperitoneal 2 (IP2) (n = 8) erythropoietin was given intraperitoneally during a 12-h dwell. Group IP1 received erythropoietin in 20 ml/kg of dialysis fluid, while in group IP2 the hormone was added to only 50 ml of dialysate, irrespective of body weight. The median area under the curve (AUC) was 4064 mU.h/ml (range 2647-24357) in group SC, 1698 (570-5514) in group IP1 and 3577 (1225-6555) in group IP2. In comparison to group SC the AUC was significantly lower in group IP1 (Wilcoxon: P = 0.02). The difference between group SC and group IP2 was not statistically significant.

Conclusion: In children on CAPD the resorption of erythropoietin after intraperitoneal administration, measured as AUC, is similar to subcutaneous administration, when erythropoietin is administered in 50 ml of dialysate. The dose needed to treat renal anaemia with erythropoietin administered intraperitoneally this way will have to be established in a therapeutic study.