Subcutaneous C.E.R.A. for the Treatment of Chronic Renal Anemia in Predialysis Patients

The likelihood of overt anemia increases as the glomerular filtration rate (GFR) declines below 60 mL/min in patients with chronic kidney disease (CKD) (1). Exogenous replacement of erythropoietin is now a well-accepted therapy in CKD (2,3) along with growing interest in the use of erythropoiesis stimulating agents (ESAs) (4). Continuous erythropoietin receptor activator (C.E.R.A.; F. Hoffmann-La Roche AG, Turkey) is an ESA developed by attaching a pegylation chain on to epoetin beta, which markedly prolonged the circulating half-life of the molecule to around 130 hours, allowing administration of the drug at extended intervals in the correction as well as maintenance periods (5,6). Our study was designed to investigate the efficacy, safety and tolerability of monthly administration of C.E.R.A. in pre-dialysis patients with chronic renal anemia (CRA) who are not currently treated with ESAs for the correction and subsequent maintenance of hemoglobin (Hb) concentrations.