Compliance with subcutaneous erythropoietin in peritoneal dialysis patients

The use of erythropoietin in dialysis patients is associated with improved quality of life and may lead to improved outcomes. Peritoneal dialysis patients are generally taught to give subcutaneous erythropoietin at home. The purpose of this study was to determine compliance with erythropoietin use in peritoneal dialysis patients. Records of patient prescriptions, refills of erythropoietin, the person administering the injection, and average hematocrit were retrospectively examined. Demographic and comorbidity data were collected prospectively on all peritoneal dialysis patients. The use of more than 90% of the prescribed dose was considered compliant. Data were available for 55 patients. The mean follow-up time was 12 months. Thirty patients (55%) were noncompliant with erythropoietin. Compliant patients were older (65.4 years vs 50 years, p = 0.01), had higher comorbidity (p = 0.01), higher average hematocrit (34% vs 31.5%, p < 0.003) and were less likely to self-administer the injection. Sex, diabetes, and compliance with dialysis exchanges were not associated with erythropoietin compliance. Using logistic regression, the only significant variable was the person administering the erythropoietin (r = 0.46, p = 0.005). Noncompliance with subcutaneous erythropoietin is a significant problem. Compliance may improve if someone other than the patient is trained to administer it.