PARTIAL CORRECTION OF DIALYSIS-ASSOCIATED ANEMIA DOES NOT REDUCE ERYTHROPOIETIN DOSE OR THE INCIDENCE OF SIDE-EFFECTS

We examined the hypothesis that administering epoetin to maintain a lo wer target haemoglobin (Hb) results in a reduced side effect profile a nd a lower maintenance epoetin dose. We report a prospective study of 14 haemodialysis patients assessing epoetin dose efficiency and side e ffect profile of partially correcting dialysis-associated anaemia. Ini tial Hb was 6.2+/-0.6 g/dl (mean+/-1 SD). Intravenous epoetin was comm enced at 120 IU/kg/week in 3 divided doses and titrated to achieve a t arget Hb of 8 g/dl. Follow-up was 24 weeks. The final Hb was 8.7+/-0.8 g/dl. The peak epoetin dose was 196+/-86 IU/kg/week with a maintenanc e dose of 141+/-71 IU/kg/week. Therapy was associated with hypertensio n - 5 patients (32%); seizures - 1 patient (6%) (withdrawn from therap y), and temporary iron deficiency - 4 patients (35%). Iron deficiency was corrected with oral therapy. There was 1 treatment failure. Compar able conventional regimens use 100-200 IU/kg to maintain the Hb at 10- 13 g/dl and have a similar incidence of side effects. We concluded tha t reducing the target Hb in order to decrease epoetin requirements is not justified as it offers no benefit over conventional Hb targets in terms of dose requirements or side effects.