Correction of anemia using self-administered daily subcutaneous erythropoietin in uremic patients on continuous ambulatory peritoneal dialysis

Abstract

We studied the effects of self-administered, daily, low-dose, subcutaneous (SC) erythropoietin (EPO) therapy in 15 uremic patients on continuous ambulatory peritoneal dialysis (CAPD) for 16 weeks to assess its efficacy and safety. The patients had baseline hemoglobin (Hb) levels of <8 g/dl and were started on 10 u/kg/day of beta-EPO. The dosage of EPO was adjusted every 4 weeks according to hematological response. The patients learned to inject into their thighs themselves. Hb increased significantly from 6.6 ± 0.2 g/dl (mean ± SEM) at week 0 to 9.0 ± 0.3 at week 8 and 10.0 ± 0.4 at week 16 (p < 0.0001). Hematocrit (Hct) increased significantly from 0.20 ± 0.01 at week 0 to 0.27 ± 0.01 at week 8 and 0.29 ± 0.001 at week 16 (p < 0.0001). The mean EPO dose was 10 u/kg/day at week 0 and 10.5 ± 0.4 at week 8 and 10.3 ± 0.5 at week 16. After minor adjustments in antihypertensive therapy had been made no significant differences in mean arterial blood pressure were noted. Six of 15 patients required increased dosage of antihypertensive drugs. All patients were given oral iron supplements. There was a significant decrease in percentage of transferrin saturation and 10 patients required additional intravenous iron supplements. There was no significant difference in the serum levels of creatinine, albumin, potassium, phosphate and urate with EPO treatment. There were no local complications at the sites of injection and the injections themselves were quite painless. We conclude that low-dose SC daily EPO is effective and safe in the correction of anemia in CAPD patients.