CROSSOVER COMPARISON OF INTRAVENOUS AND SUBCUTANEOUS ERYTHROPOIETIN IN HEMODIALYSIS-PATIENTS

To examine the suggestion that s.c. administration of recombinant huma n erythropoeitin (rHuEpo) may be more effective than i.v. administrati on, we changed the route of administration in 11 patients, previously established on a stable dose of rHuEpo given twice or thrice weekly, f rom i.v. to s.c. administration without altering the dose. All patient s were iron replete (serum ferritin > 100-mu-g/l). In one patient the haemoglobin concentration declined at the time of conversion due to po or compliance, and another patient died shortly after conversion. In t he remainder there was a significant increase in haemoglobin concentra tion from 9.30 (SD 0.78) at the time of conversion to 9.84 (0.59) at 1 month, 10.35 (1.22) at 2 months, and 10.39 (1.42) at 3 months. The in crease in haemoglobin concentration was greater than 1 g/dl at 3 month s in only five of the patients. Serum ferritin prior to conversion was similar in 'responders' and 'non-responders', but all responders had a transferrin saturation of > 16%, whereas three of four non-responder s had transferrin saturation of less-than-or-equal-to 16%. Subcutaneou s administration of rHuEpo is more effective, dose for dose, than i.v. administration, but poor iron mobilization may limit the response.