ANEMIA CORRECTION IN DIALYSIS PATIENTS WITH ONCE A WEEK SUBCUTANEOUS RECOMBINANT-HUMAN-ERYTHROPOIETIN

Recombinant Human Erythropoietin (rHuEPO) has been shown to be effective in correcting anemia of uremic patients. In the literature, the initial intravenous dose to raise the hematocrit to a target level of 35% was 50 IU/kg body weight or above. Elevation of blood pressure and hypertensive encephalopathy are most frequent severe complications. In order to minimize complications and increase comfort and efficiency we studied the use of 4,000 IU of rHuEPO subcutaneous once weekly after dialysis. We studied ten patients on regular hemodialysis, six males and four females with a mean age af 57 +/- 18. During four months we studied monthly: blood counts, ferrokinetics and biochemical parameters as well as symptoms and complications. All patients responded to treatment and presented a slow but regular increase in Hct (24.6 +/- 3.6 vs. 30.6 +/- 3.0) and Hb (8.5 +/- 1.2 vs. 10.6 +/- 0.7). At the end of the study eight of ten had Hct between 30 and 35% and two between 28 and 30%. Treatment was well tolerated without severe side effects. No hypertensive encephalopathy, thrombosis or seizures were observed. It was not necessary to increase antihypertensive medication. In summary, the administration of 4,000 IU of rHuEPO subcutaneously once weekly is a safe, efficient and comfortable way of treating anemia during hemodialysis.