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Table of Contents
Vol. 102, No. 3-4, 2006
Issue release date: February 2006
Section title: Original Paper
Nephron Clin Pract 2006;102:c88–c92
(DOI:10.1159/000089665)

Erythropoietin-Alpha Dosage Requirements in a Provincial Hemodialysis Population: Effect of Switching from Subcutaneous to Intravenous Administration

Raymond C.B.a · Collins D.M.b · Bernstein K.N.c, d · Skwarchuk D.E.c · Vercaigne L.M.b, c
aRenal Drug Use Management Initiative, Winnipeg Regional Health Authority; bFaculty of Pharmacy, University of Manitoba; cManitoba Renal Program, and dDepartment of Internal Medicine (Section of Nephrology), Faculty of Medicine, University of Manitoba, Winnipeg, Canada

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: January 21, 2005
Accepted: June 07, 2005
Published online: November 11, 2005
Issue release date: February 2006

Number of Print Pages: 1
Number of Figures: 0
Number of Tables: 4

ISSN: (Print)
eISSN: 1660-2110 (Online)

For additional information: http://www.karger.com/NEC

Abstract

Background: The purpose of this initiative was to compare erythropoietin-α doses in hemodialysis patients who changed from subcutaneous to intravenous administration. The Manitoba Renal Program switched routes due to concern about erythropoietin-associated pure red cell aplasia. Methods: We compared the erythropoie tin-α dosage requirements during subcutaneous administration (3 months pre-switch) and intravenous administration (months 4–6 post-switch). We also compared: hemoglobin, transferrin saturation (Tsat%), ferritin, and percent of patients receiving intravenous iron. The same erythropoietin-α regimen was initially used when patients were switched. Results: Of the 628 patients receiving erythropoietin-α, the data were complete for 400. The dose increased 26% (mean ± SD, 10,425 ± 7,330 vs. 13,125 ± 8,638 IU/week; p < 0.0001), despite similar hemoglobin, (mean ± SD, 11.5 ± 1.1g/dl (114.9 ± 11.2 g/l) vs. 11.3 ± 1.0 g/dl (113.5 ± 10.4 g/l); p = 0.0450) and iron parameters (Tsat 30.9%, ferritin 464 ng/ml (µg/l) vs. Tsat 28.7%, ferritin 538 ng/ml (µg/l)). For the subgroup of 84 patients who maintained target hemoglobin (10–11 g/dl or 110–120 g/l) for both periods, the dose increased 26% (mean ± SD, 8,393 ± 6,242 vs. 10,589 ± 7,049 IU/week; p < 0.0001) without a change in hemoglobin, (mean ± SD, 11.5 ± 0.3 g/dl (115.2 ± 3.0 g/l) vs. 11.5 ± 0.3 g/dl (114.9 ± 3.3 g/l); p = 0.5789). When stratified by subcutaneous dose, patients with the lowest dose (<5,000 IU/week) demonstrated the greatest increase (89%), and those with the highest dose (>20,000 IU/week) experienced no increase (–3%). Conclusion: Overall, erythropoietin-α doses increased by 26% when patients were converted from subcutaneous to intravenous administration.

© 2006 S. Karger AG, Basel


Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: January 21, 2005
Accepted: June 07, 2005
Published online: November 11, 2005
Issue release date: February 2006

Number of Print Pages: 1
Number of Figures: 0
Number of Tables: 4

ISSN: (Print)
eISSN: 1660-2110 (Online)

For additional information: http://www.karger.com/NEC


Copyright / Drug Dosage / Disclaimer

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.