Nineteen anemic chidren (13 boys & 6 girls, mean age: 10±4 years) with chronic renal failure (CRSF0 were treated with recombinant human erythropoietin (rHuEPO0 for more then six months. Fifteen of the children were on replacement therapy (10 on
hemodialysis, 5 on CAPD0, and four were managed conservatively. Initial response to weekly dosage; To raise patient's hematocrit over 30%, dosage over 180U/;kg/wk took a month, 150-180 U/kg/week took two months, and below 150 U/kg/week took more
than
three months. To maintain hematocrit between 27% and 33%, 136±49U/kg/wk of rHuEPO was necessary, with significant individual variations (range: 55-250 U/kg/wk). Regarding the effect of rHuEPO, we found no difference between intravenous and
subcutaneous
administration in both inital and maintenance treatment. Relative drug resistance was noted in four children, in whom myelofibrosis associated with hyperparathyroidism seemed to be the leading cause. Both the number of patients who needed
transfusion,
and the number of transfusions in each patient decreased significantly after rHuEPO therapy. During the treatment period, all children needed iron supplementation, 47% needed initiation or initiation or addition of antihypertensive medications.
Thrombosis of the arteriovenous fistula developed in two children on hemodialysis. Changes in BUN, serum creatinine, potassium, and phosphorus were not significant.
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