The Treatment of Anemia with Low-Dose Recombinant Human Erythropoietin

Abstract

Recombinant human erythropoietin is effective therapy for the anemia of chronic renal failure. Hypertension, seizures, dialysis access thromboses, and clotted dialyzers have been reported as problems associated with the use of this drug. To test the hypothesis that low-dose erythropoietin is effective and safe, we gave 37 chronic hemodailysis patients this compound (3,000 units, i.v.) three times each week for 3 months. Before and for 3 months during therapy, we measued hemoglobin, hematocrit, blood transfusion, blood pressure, access thromboses, seizures, and clotted dialyzers. After 2 months of treatment, mean hemoglobin concentration and mean hematocrit increased significantly. Five patients had no increse in either value. In 4 of these 5 nonsresponders, blood loss accounted for treatment failure. Neither blood pressure nor the incidence of access thrombses, seizures, and clotted dialyzers changed during the 3 months of therapy. We conclude that recombinant human erythropoietin is effective as treatment for the anemia of chronic renal failure at much lower doses that have been reported previously. The low incidence of adverse events may be related to the low dose used.