Name of the Procedure:

Injection, Peginesatide, 0.1 mg (for ESRD on dialysis)
Common Names: Peginesatide Injection
Technical/Medical Terms: Peginesatide, Erythropoiesis-stimulating agent (ESA)

Summary

This procedure involves administering an injection of Peginesatide, a medication designed to stimulate the production of red blood cells, which is particularly beneficial for patients with End-Stage Renal Disease (ESRD) who are on dialysis.

Purpose

Peginesatide is used to treat anemia in patients with ESRD on dialysis. The goals are to increase red blood cell counts, reduce the need for blood transfusions, and alleviate symptoms of anemia such as fatigue, weakness, and shortness of breath.

Indications

• Chronic kidney disease (CKD) associated anemia
• End-Stage Renal Disease (ESRD) in patients undergoing dialysis
• Hemoglobin levels that are persistently low

Preparation

• No fasting or special dietary preparations are usually needed.
• Inform the healthcare provider about all current medications and supplements.
• A baseline complete blood count (CBC) and renal function tests might be required.

Procedure Description

1. The healthcare provider will first sanitize the injection site.
2. Peginesatide is administered via a subcutaneous (under the skin) or intravenous (IV) injection.
3. The dosage is calculated based on the patient's weight and hemoglobin levels.
4. Vital signs may be monitored before, during, and after the injection.
5. The injection usually takes only a few minutes to administer.

Duration

The actual injection process typically takes a few minutes, though the entire appointment may last up to an hour to include preparation and monitoring.

Setting

• Hospital
• Outpatient dialysis centers
• Specialized clinics

Personnel

• Nephrologist or dialysis nurse to administer the injection
• Medical assistant to help with preparation and monitoring

Risks and Complications

• Common: Localized pain or irritation at the injection site, headache, dizziness
• Rare: Hypertension, thromboembolic events, allergic reactions
• Management includes monitoring, appropriate medication adjustments, and emergency intervention if severe reactions occur.

Benefits

• Increase in red blood cell count
• Reduction in the need for blood transfusions
• Improvement in symptoms of anemia, typically noticeable within a few weeks

Recovery

• Most patients can resume normal activities immediately.
• Follow-up blood tests to monitor hemoglobin levels and adjust dosage if necessary.
• Reporting any side effects or adverse reactions promptly to the healthcare provider.

Alternatives

• Other erythropoiesis-stimulating agents (ESAs) like Epoetin alfa or Darbepoetin alfa
• Frequent blood transfusions
• Pros: Other ESAs have more established histories
• Cons: Higher risk of iron overload with transfusions, possible allergic reactions to different medications

Patient Experience

• Mild discomfort from the injection
• Post-procedure site soreness or bruising
• Effective pain management techniques like using ice packs and over-the-counter pain relievers
• Overall improvement in energy levels and reduction in anemia symptoms over time