Subcutaneous treatment with recombinant human erythropoietin--the influence of injection frequency and skin-fold...

Subcutaneous treatment with erythropoietin (epoetin) in patients undergoing continuous ambulatory peritoneal dialysis (CAPD) is convenient, but the optimal injection frequency is under discussion. Epoetin was given subcutaneously to 22 stable anaemic CAPD patients in doses that adjust haemoglobin to 7.2+/-0.3 mmol/l during a correction period. During the maintenance period the frequency of injections in four randomized groups of patients was changed randomly to once, twice or three times a week or daily. Each period lasted more than 8 weeks. During the maintenance period the epoetin dose was almost unchanged, whether the patients were treated once, twice or thrice weekly. In 15 patients treated with daily injections, the overall dose reduction was 22%. These 15 patients were grouped arbitrarily into 7 patients with a skin-fold of more than 20 mm at the injection site, and 8 patients with a skin-fold of less than 20 mm at the injection site. The dose reduction correlated with skin-fold thickness; the reduction was seen only in the patients with skin-folds of less than 20 mm. Seven of the eight patients experienced an average dose reduction of 36+/-8%.