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Nephrology Dialysis Transplantation, Vol 13, Issue 1 89-92, Copyright © 1998 by Oxford University Press

ORIGINAL ARTICLES

Continuous intravenous intradialysis versus intravenous postdialysis erythropoietin therapy in chronic haemodialysis patients: a randomized, controlled, crossover study

J Rocha, M Gentil, M Gili, L Gil, V Cabello and G Bernal
Division of Nephrology, Unit of Clinical and Experimental Research, Virgen del Rocio University Hospital, Avda. Manuel Siurot s/n, E-41013 Seville, Spain; Dialysis Unit, Virgen de la Merced Hospital, Osuna, Seville, Spain; Corresponding author

Background: Subcutaneous recombinant human erythropoietin seems to be more effective than intravenous administration. Local pain, however, may diminish patient compliance with the subcutaneous route. Recently continuous intravenous intradialysis administration of rHuEpo has been reported to be more efficacious in stimulating erythropoiesis than the usual postdialysis intravenous bolus. Methods: We conducted a randomized, controlled, crossover study on stable chronic haemodialysis patients to compare the efficacy of continuous intradialysis rHuEpo therapy with intravenous postdialysis administration. Twenty patients were selected and randomly assigned to receive rHuEpo either postdialysis (control phase) or by continuous intradialysis perfusion (slow Epo phase) for 12 weeks. After this period, patients were switched to the alternative method for 12 additional weeks. The erythropoietin dose remained unchanged during the study. Haematocrit was monitored weekly and iron metabolism, serum Epo, and vitamins were measured monthly. Urea kinetics and iPTH measurements were performed every 3 months. Results: Three patients were excluded because of unrelated problems. The final mean haematocrit was unchanged from previous basal values in both phases and no statistical differences were found for any parameter between the groups. No differences were found in iron metabolism nor in urea kinetic parameters. Conclusions: Continuous intravenous intradialysis administration of rHuEpo is no more effective than an intravenous postdialysis bolus as rHuEpo maintenance therapy in stable chronic haemodialysis patients. Key words: anaemia; chronic kidney failure; continuous intravenous infusion; crossover study; haemodialysis rHuEpo; route of administration
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