[Treatment of renal anemia with intravenous erythropoietin in patients in the program of continuous ambulatory peritoneal dialysis].
OBJECTIVE
In the face of non fully correctable renal anemia in patients on continuous ambulatory peritoneal dialysis (CAPD) injecting erythropoetin subcutaneously by themselves, we compared the effectiveness of renal anemia compensation as well as potentially positive influence on the clinical course of CAPD erythropoietin alpha (EPOalpha) given intravenously 1 or 2 times weekly, by PD-nurse at patients home with the same protocol of erythropoietin beta (EPObeta) given subcutaneously by patient himself or by family helper.


METHODS
There were 2 groups of CAPD patients qualified in years 2003-2005 to the 6 months study. Group 1 consisted of 12 patients who were receiving EPOalpha intravenously (7 women and 5 men; aged 57.8 +/- 14.0 years) and group 2 consisted of 12 patients who were given EPObeta subcutaneously by themselves (7 women and 5 men; age 58.0 +/- 12.5 years). In the course of home visits the nurses supervised the correctness of CAPD program performed by patient or family helper.


RESULTS
The results were as follows: we observed significant increase of the Hgb level in the group 1 between 3-rd and 6-th month of the study without significant increase of EPO dose. With respect to the course of CAPD program we found significantly higher frequency of peritonitis (1/11 vs 1/68 patient months; p < 0.05) and longer mean time of hospitalization (2.33 +/- 1.97 vs 1.17 +/- 1.03 days/pt; p < 0.05) in the group 2 in comparison with group 1. Mean peritonitis-free survival time was significantly longer in the group 1 in comparison with the group 2 (22.14 +/- 6.41 vs 16.51 +/- 9.70 weeks; p < 0.05).


CONCLUSIONS
We conclude that EPOalpha given intravenously by PD-nurse in patient home enabled maintenance of recommended Hgb level. The additional benefit from nurse assisted PD was reduction of peritonitis rate as well as duration of hospitalization from various reasons.
Zelichowski
Grzegorz
G
Wojskowy Instytut Medyczny w Warszawie, CSK MON, Klinika Chorób Wewnetrznych, Nefrologii i Dializoterapii. grzegorz@wim.mil.pl
Lubas
Arkadiusz
A
Sienkiewicz
Marzena
M
Janusz
Elzbieta
E
Wańkowicz
Zofia
Z
D000328:Adult; D000368:Aged; D000740:Anemia / Q000188:drug therapy* / Q000209:etiology*; D004921:Erythropoietin / Q000008:administration & dosage*; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007275:Injections, Intravenous; D007279:Injections, Subcutaneous; D007676:Kidney Failure, Chronic / Q000150:complications*; D008297:Male; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory; D016896:Treatment Outcome
D006454:Hemoglobins; D004921:Erythropoietin