Outcome of Daprodustat in Bangladeshi Non Dialysis CKD Patients

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Outcome of Daprodustat in Bangladeshi Non Dialysis CKD Patients

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Co-author 1

Debaleena Das Gupta debaleenadoc@gmail.com M A G Osmani Medical College Pharmacology Sylhet Bangladesh *

Co-author 2

Shubharthi Kar shubharthi@gmail.com Habiganj Medical College Nephrology Habiganj Bangladesh -

Co-author 3

Shiful Islam shifulislam@gmail.com Jalalbad Ragib Rabeya Medical College Internal Medicine Sylhet Bangladesh -

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Introduction

Renal anemia is a big concern for physicians. Daprodustat has not been approved in non dialysis CKD by most of the countries in the world. We evaluated effect of Daprodustat in non dialysis CKD patients in Bangladesh.

Methods

This was a cross sectional study on stage III to stage V CKD who were not on dialysis . Patients were recruited by purposive sampling and followed up for a period of 6 months. Patients were not on ESA therapy priorly. Hemoglobin less than 8 gm/dl was excluded from the study. Each patient received 4 mg Daprodustat daily initially if inadequate response then we incremented 6 mg daily.

Results

We recruited 30 CKD patients with adequate Iron status. 22 (73.3%) patients were diabetic and 25 (83.3%) were hypertensive. No one had prior evidence of ischemic heart disease. Mean eGFR during recruitment was 20.55 ml/min and after 6 months was 23.95 ml/min. Mean Hemoglobin was 9.2 gm/dl. After 3 months mean hemoglobin was 10.44 gm /dl and after 6 months it was 11.12 gm/dl. No major cardiovascular adverse effect was observed during this period. No clinical features of malignancy was found at 6 months. Fundoscopy was done periodically and we did not observe any deterioration of diabetic retinopathy. However we could not avail fundal photographs. Adherence to treatment was satisfactory. Treatment with Daprodustat was cost effective as Darbepoetin costs 8000 to 16000 BDT per month ( USD 65 to 130 USD ) and Daprodustat costs only 2700 to 4200 BDT ( USD 22 to 34) per month in Bangladesh.

Conclusion

Daprodustat can be a cost effective treatment of non dialysis CKD patients in Bangladesh. Larger studies needed to evaluate its efficacy and side effects in non dialysis CKD patients on Bangladeshi Population.

Kewords