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Conversion From Subcutaneous to Intravenous Erythropoietin in a Hemodialysis Population

From the Faculty of Pharmacy, University of Manitoba, Winnipeg, Manitoba, Canada (Dr Vercaigne, Dr Collins); Manitoba Renal Program, Winnipeg, Manitoba, Canada (Dr Vercaigne); and Departments of Pharmacology and Therapeutics and Internal Medicine, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada (Dr Penner).

The purpose of this study was to compare erythropoietin dosage requirements during subcutaneous versus intravenous administration in a hemodialysis population. Hemodialysis patients receiving subcutaneous epoetin alfa were switched to the intravenous route using a prospective, crossover design. Baseline anemia parameters were measured at months –2, –1, and 0 when patients were receiving subcutaneous dosing and compared to months 4, 5, and 6 after the switch to intravenous dosing. Ninety-eight patients were enrolled into the study with an average age of 54.8 years. Over the course of the study, 34 patients were excluded from analysis, leaving 64 patients with complete hemoglobin and erythropoietin dosing data throughout the subcutaneous and intravenous evaluation periods. In these patients, the dose of erythropoietin increased significantly from the subcutaneous to the intravenous period (7567.7 to 10229.2 IU/wk). The conversion of hemodialysis patients from the subcutaneous to the intravenous route of administration significantly increased epoetin alfa dosage requirements.

Key Words: Erythropoietin • intravenous • dosing • subcutaneoushemo • dialysis

Address for reprints: Lavern M. Vercaigne, PharmD, Office 407 B, Faculty of Pharmacy, University of Manitoba, 50 Sifton Road, Winnipeg, Manitoba, Canada.

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