Must erythropoietin be injected by the subcutaneous route for every hemodialyzed patient?

Virot, Jean Simon; Janin, G.; Guillaumie, J; Michel, Patrik; Dubot, P.; Chevet, D; Rifle, G

doi:10.1016/s0272-6386(96)90498-9

Cited by 30 publications

(15 citation statements)

References 25 publications

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“…In Europe and the USA, many clinical studies comparing intravenous and subcutaneous injections revealed that subcutaneous injection of rHuEPO is more advantageous than intravenous injection in terms of the improvement in anemia and its long-lasting effect, as well as costeffectiveness [64][65][66][67][68][69][70][71][72][73][74][75][76][77]. In the conventional European and US guidelines on therapy for renal anemia [78,79], subcutaneous injection was also recommended for HD patients.…”

Section: (2)target Hb Levels To Be Maintained In Pd Patientsmentioning

confidence: 99%

2015 Japanese Society for Dialysis Therapy: Guidelines for Renal Anemia in Chronic Kidney Disease

Yamamoto¹,

et al. 2017

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Section: (2)target Hb Levels To Be Maintained In Pd Patientsmentioning

confidence: 99%

2015 Japanese Society for Dialysis Therapy: Guidelines for Renal Anemia in Chronic Kidney Disease

Yamamoto¹,

et al. 2017

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“…dosage requirements than patients with baseline erythropoietin doses of >140 IU/kg/week. However, one of these only included 9 patients in this high-dose subgroup [21], and the other did not provide sample size information for the high-dose subgroup [7]. Our data do not support this finding.…”

Section: Discussionmentioning

confidence: 56%

“…Two published studies [7, 21] have suggested that patients with baseline erythropoietin doses of >140 IU/kg/week showed a greater difference between s.c. and i.v. dosage requirements than patients with baseline erythropoietin doses of >140 IU/kg/week.…”

Section: Discussionmentioning

confidence: 99%

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

Raymond

Collins²,

Bernstein³

et al. 2005

Nephron Clin Pract

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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.

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“…However, this finding must be interpreted with caution as a similar observation has been reported after a switch from i.v. to s.c. treatment [3,10]. Thus, the decrease in epoetin required by patients receiving high weekly s.c. doses in the present survey may not necessarily be a consequence of the switch of administration route.…”

Section: Discussionmentioning

confidence: 99%

Effect of switching from subcutaneous to intravenous administration of epoetin-α in haemodialysis patients: Results from a Swedish multicentre survey

Linde

Furuland

Wíkström

2005

Scandinavian Journal of Urology and Nephrology

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Must erythropoietin be injected by the subcutaneous route for every hemodialyzed patient?

Cited by 30 publications

References 25 publications

2015 Japanese Society for Dialysis Therapy: Guidelines for Renal Anemia in Chronic Kidney Disease

2015 Japanese Society for Dialysis Therapy: Guidelines for Renal Anemia in Chronic Kidney Disease

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

Effect of switching from subcutaneous to intravenous administration of epoetin-α in haemodialysis patients: Results from a Swedish multicentre survey

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