Recombinant human erythropoietin utilization in Department of Veterans Affairs dialysis units.
This study was carried out to determine the use of recombinant human erythropoietin (rHuEPO) in the Veterans Affairs dialysis program and any strategies being carried out to enhance its effectiveness. The data were collected from a survey that was conducted using a questionnaire sent to all Veterans Affairs dialysis programs. The survey included all patients treated with hemodialysis or peritoneal dialysis for at least 3 months and who were receiving rHuEPO for at least 3 months. Patients diagnosis, age, length of time of dialysis, mode of dialysis, length of rHuEPO treatment, route of administration, assessment of iron stores, use of iron supplementation, and use of androgens were assessed by this questionnaire and analyzed for their effect on dose required to achieve a target hematocrit. Subcutaneous administration resulted in a significantly lower dose requirement compared with the dose required when rHuEPO was administered intravenously. Concomitant use of androgens resulted in a lower dose requirement for rHuEPO when it was given intravenously, but not when rHuEPO was given subcutaneously. The dose required to maintain the hematocrit at the designated level appeared to increase with time of treatment.