WORLD JOURNAL OF ADVANCE
HEALTHCARE RESEARCH

Marwah Safaa Ahmed*, Mohammed Hannon Al-Sodani

ABSTRACT

Introduction: Chronic kidney disease (CKD) stands as a leading cause of global mortality in the 21st century, recent updates as of 2022 indicate that CKD has affected over 800 million people worldwide, with a growing prevalence. (1) In 2023, Iraq recorded a total of 10,721 patients undergoing HD, with an estimated population of 45.5 million, resulting in a prevalence rate of 235.6 patient per million. Anemia is an almost universal complication of chronic kidney disease (CKD). The use of ESAs in the management of renal anemia has been shown to improve survival, reduce cardiovascular morbidity, and enhance quality of life and needs of blood transfusion and its complication. Short half-life Epoetin alfa is a primary choice for treating anemia in patients with CKD. [2]. Darbepoetin alfa, as a second?generation long?acting recombinant erythropoietin preparation, is a new recombinant glycoprotein. Methods: Retrospective study with analytical element was conducted from 1st of November 2023 to 31 of January 2025 in the Iraqi center of hemodialysis at Baghdad teaching hospital. In our center the erythropoietin stimulating agent as treatment for anemia was switched for all patients from erythropoietin alpha (Eprex) to darbepoetin alpha (Aransep) in May of 2025. So, the hemoglobin level for 3 consecutive months between Nov. 2023 to April 2024 were studied in Eprex arm, and from May 2024 to Feb. 2025 for Aransep arm. Results: A total of 95 patients who met the eligibility criteria were enrolled in this study. The demographic and clinical characteristics of patients were studied. The mean Age of patients was 52.5±15.2 (18-76), 55.8% of patient was male. The main cause of CKD in studied patients was hypertension (HT) 39 (41%) then diabetic nephropathy 20 (21%) is second cause. The hemoglobin level was studied for three consecutive months in the erythropoietin alpha and darbepoetin group. The mean hemoglobin in each group was 10.0±1.4 (6.4-13), 9.8±1.2 (6.4-12.3) respectively with no statically significant p value: 0.180 between two group. The target level (10–12g/dl) of mean hemoglobin was achieved by 47.4% by epoetin alpha compared to 41.1% by darbepoetin with no significant difference between the two drugs in achieving this target Hb range (P value 0.45). Conclusion: Darbepoetin alpha shows no inferiority for corrected anemia compared to epoetin alpha in hemodialysis patients, with no major side effect that needs discontinuation of drug.