EFFECTIVENESS OF LOW-DOSE ERYTHROPOIETIN IN PREDIALYSIS CHRONIC-RENAL-FAILURE PATIENTS

Recombinant human erythropoietin (rHuEpo) has been shown to be both ef fective and usually safe in patients with chronic renal failure who ha ve not yet reached the stage requiring dialysis. There are, however, d isturbing reports on the possibility of deterioration of the reserve r enal function in association with rHuEpo therapy. Most of the publishe d studies have used rHuEpo in doses of 50-150 U/kg three times weekly subcutaneously. An open-label trial of rHuEpo therapy was conducted on 21 patients with chronic renal failure treated sequentially at a refe rral hospital, rHuEpo was used in doses of 50 U/kg twice weekly for 4 weeks followed by 25 U/kg twice weekly for 8 weeks subcutaneously, a r egimen substantially lower than current recommendations. This was asso ciated with a gentle but significant increase in haematocrit (P<0.05) and haemoglobin (P<0.05), while the serum creatinine and the reciproca l of the creatinine remained stable, with a tendency to improve rather than worsen (P=0.06). We conclude that there is no need to aim at a r apid increase in haematocrit and haemoglobin by rHuEpo therapy; rather a gentle increase using modest doses is both effective and safe.