Efficacy prospective study of different frequencies of Epo administration by i.v. and s.c. routes in renal replacement therapy patients

Piergiorgio Messa, Maria Angela Nicolini, Bruno Cesana, Brigida Brezzi, Tito Zattera, Alberto Magnasco, Gabriella Moroni, Mariarosaria Campise

Research output: Contribution to journalArticle

Abstract

Background. The problem of pure red cell aplasia (PRCA) prompted nephrologists to revert to a wider intravenous (i.v.) utilization of erythropoeitin (Epo). Once weekly i.v. Epo administration has been suggested to be as effective as the twice/thrice weekly i.v. dose. The aim of the present study was to test whether once weekly i.v. Epo administration is equally as cost-effective as once weekly subcutaneous (s.c.) and 2-3 times weekly i.v. administration. Methods. We prospectively studied 41 patients (23 males, aged 28-82 years), on renal replacement therapy for 18-286 months, stabilized on twice or thrice weekly s.c. Epo-α (basal). The patients were treated for three consecutive 6 month periods with once weekly s.c. (OWSC), once weekly i.v. (OWIV) and twice/thrice weekly i.v. (TWIV) Epo-α. The initial dose for each period was equal to the final dose of the previous one; when necessary, the dose was adjusted according to DOQY guidelines. Iron, folic acid and vitamin B12 supplementations were given throughout all the study periods. At the end of each of the four study periods, the following parameters were evaluated: haemoglobin, haematocrit, hypochromic red blood cells (RBCs), iron, serum ferritin, transferrin, folate, vitamin B12, C-reactive protein (CRP), Kt/V, parathyroid hormone (PTH) and weekly dose of Epo-α. Results. Thirty-three out of 41 enrolled patients completed the study (there were five deaths, two renal transplants and one transfer). No significant changes were observed as regards iron, serum ferritin, transferrin, folate, vitamin B12, CRP, Kt/V or PTH level. Haemoglobin levels were not different at the end of the basal (11.7±1.21), OWSC (11.8±0.86) and TWIV (12.1±1.04) periods, while significantly lower levels were observed after the OWIV period (11.0 ± 0.97, Pa; and TWIV 11.89 ± 6.3*a (*P <0.01 vs basal; aP <0.01 OWSC). Conclusions. From our results, the OWIV schedule seems to have less efficacy in the control of anaemia of chronic renal failure patients on dialysis treatment than either OWSC or TWIV schedules.

Original languageEnglish
Pages (from-to)431-436
Number of pages6
JournalNephrology Dialysis Transplantation
Volume21
Issue number2
DOIs
Publication statusPublished - Feb 2006

Keywords

  • Anaemia
  • Chronic renal failure
  • Erythropoietin

ASJC Scopus subject areas

  • Nephrology
  • Transplantation

Fingerprint Dive into the research topics of 'Efficacy prospective study of different frequencies of Epo administration by i.v. and s.c. routes in renal replacement therapy patients'. Together they form a unique fingerprint.

  • Cite this