Erythropoietin with oral iron in peritoneal and hemodialysis patients. A comparison in an inner city population.
Studies on the comparative efficacy of erythropoietin (rHuEPO) in chronic hemodialysis (HD) and peritoneal dialysis (PD) patients are scarce. The authors compared the use of rHuEPO in 74 stable patients on hemodialysis with 24 on chronic peritoneal dialysis. All patients were on oral iron supplements. In PD patients, hematocrits were 23.1 and 30.1%, rHuEPO dose 80.9 and 89.0 U/kg/wk, whereas in HD patients, hematocrits were 21.2 and 27.5 and rHuEPO dose was 140.2 and 165.0 U/kg/wk at initiation and 6 months, respectively. Serum iron and transferrin saturations were unchanged in peritoneal, but decreased in hemodialysis patients on rHuEPO therapy. These findings suggest that rHuEPO is more effective in peritoneal dialysis patients than in hemodialysis patients receiving oral iron. The improved efficacy of rHuEPO in peritoneal dialysis may be due to decreased blood loss, subcutaneous administration, or better removal of inhibitors of erythropoiesis. Peritoneal dialysis may be more cost effective and desirable than hemodialysis for rHuEPO dependent or resistant patients.
Raja
R
R
Kraftsow Division of Nephrology, Albert Einstein Medical Center, Philadelphia, PA 19141.
Bloom
E
E
Goldstein
M
M
Johnson
R
R
D000284:Administration, Oral; D002352:Carrier Proteins / Q000378:metabolism; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004921:Erythropoietin / Q000008:administration & dosage*; D005293:Ferritins / Q000378:metabolism; D006400:Hematocrit; D006801:Humans; D007262:Infusions, Intravenous; D007279:Injections, Subcutaneous; D007501:Iron / Q000008:administration & dosage*; D033862:Iron-Binding Proteins; D007676:Kidney Failure, Chronic / Q000097:blood / Q000628:therapy*; D010531:Peritoneal Dialysis, Continuous Ambulatory; D011994:Recombinant Proteins / Q000008:administration & dosage; D006435:Renal Dialysis; D033863:Transferrin-Binding Proteins; D014505:Urban Population
D002352:Carrier Proteins; D033862:Iron-Binding Proteins; D011994:Recombinant Proteins; D033863:Transferrin-Binding Proteins; D004921:Erythropoietin; D005293:Ferritins; D007501:Iron