Subcutaneous Compared with Intravenous Epoetin in Patients Receiving Hemodialysis

In patients with end-stage renal disease, treatment of anemia with recombinant human erythropoietin (epoetin) has improved cardiovascular function and the quality of life. 1 , 2 However, these benefits come at substantial economic cost, with 1994 Medicare expenditures for epoetin therapy exceeding $700 million. Efforts to optimize the use of epoetin have been aimed at increasing the efficiency of administration and addressing factors that may cause resistance to the hormone, such as iron deficiency, hyperparathyroidism, and inadequate hemodialysis. 3 – 5 The initial clinical trials of epoetin were performed in patients undergoing hemodialysis, with the drug administered intravenously during hemodialysis. Pharmacokinetic studies indicating that . . .