Abstract
We undertook a study of the optimal route of administration and dosage of recombinant human erythropoietin (EPO) for the treatment of renal anemia in patients undergoing continuous ambulatory peritoneal dialysis (CAPD).
Sixteen clinically stable patients (9 males, 7 females; mean age 45 years) undergoing CAPD were selected for this study. Weekly intravenous (i.v.) administration of EPO was switched to weekly subcutaneous (s.c.) administration. Changes in hemoglobin (Hb) concentration were observed. The rates of increase in Hb concentration between twice weekly i.v. EPO 6, 000U and weekly s.c. EPO 6, 000U were compared. Twelve patients who received EPO subcutaneously were divided into four groups. Group 1 (n=5) received 6, 000U weekly. Group 2 (n=3) received 9, 000U biweekly. Group 3 (n=3) received 6, 000U biweekly. Group 4 (n=1) received 9, 000U monthly. The maintenance dose and schedule of subcutaneous treatment in all patients were studied. The maintenance dose of EPO was also determined in hemodialysis (HD) and CAPD patients.
The initial and maintenance therapy with subcutaneous administration are more effective than intravenous treatment in CAPD patients. Biweekly s.c. EPO 6, 000-9, 000U administration showed a sufficient response in correction of anemia, and Hb levels were maintained by biweekly s.c. EPO 1, 500-9, 000U (mean: 6, 094U) administration. Maintenance doses in CAPD patients who received s.c. EPO showed a tendency to decrease as compared with those of HD patients who received i.v. EPO. No anti-EPO antibodies were detected in any patients.
Taking quality of life into consideration, s.c. EPO is recommended for correction of anemia in CAPD patients.
