Address of Corresponding Author

Nephron Clin Pract 2006;102:c88-c92 (DOI: 10.1159/000089665)

  Key Words

• Erythropoietin- administration
• Subcutaneous
• Intravenous

  Abstract

Background: The purpose of this initiative was to compare erythropoietin- doses in hemodialysis patients who changed from subcutaneous to intravenous administration. The Manitoba Renal Program switched routes due to concern about erythropoietin-associated pure red cell aplasia. Methods: We compared the erythropoie tin- dosage requirements during subcutaneous administration (3 months pre-switch) and intravenous administration (months 4-6 post-switch). We also compared: hemoglobin, transferrin saturation (Tsat%), ferritin, and percent of patients receiving intravenous iron. The same erythropoietin- regimen was initially used when patients were switched. Results: Of the 628 patients receiving erythropoietin-, the data were complete for 400. The dose increased 26% (mean ± SD, 10,425 ± 7,330 vs. 13,125 ± 8,638 IU/week; p < 0.0001), despite similar hemoglobin, (mean ± SD, 11.5 ± 1.1g/dl (114.9 ± 11.2 g/l) vs. 11.3 ± 1.0 g/dl (113.5 ± 10.4 g/l); p = 0.0450) and iron parameters (Tsat 30.9%, ferritin 464 ng/ml (µg/l) vs. Tsat 28.7%, ferritin 538 ng/ml (µg/l)). For the subgroup of 84 patients who maintained target hemoglobin (10-11 g/dl or 110-120 g/l) for both periods, the dose increased 26% (mean ± SD, 8,393 ± 6,242 vs. 10,589 ± 7,049 IU/week; p < 0.0001) without a change in hemoglobin, (mean ± SD, 11.5 ± 0.3 g/dl (115.2 ± 3.0 g/l) vs. 11.5 ± 0.3 g/dl (114.9 ± 3.3 g/l); p = 0.5789). When stratified by subcutaneous dose, patients with the lowest dose (<5,000 IU/week) demonstrated the greatest increase (89%), and those with the highest dose (>20,000 IU/week) experienced no increase (-3%). Conclusion: Overall, erythropoietin- doses increased by 26% when patients were converted from subcutaneous to intravenous administration.

Copyright © 2006 S. Karger AG, Basel

  Author Contacts

Colette Raymond, Pharm.D.
Winnipeg Regional Health Authority
16th Floor - 155 Carlton Street
Winnipeg, Man. R3C 4Y1 (Canada)
Tel. +1 204 926 7143, Fax +1 204 943 1792, E-Mail umraymoc@cc.umanitoba.ca

  Article Information

Received: January 21, 2005
Accepted: June 7, 2005
Published online: November 10, 2005
Number of Print Pages : 5
Number of Figures : 0, Number of Tables : 4, Number of References : 21