Our experience with epoetins in treating renal anemia

Epoetin treatment of renal anemia has been practiced in Slovenia since 1988. More than 90% of hemodialysis patients and 83% of peritoneal dialysis patients have been treated with epoetin. Epoetin has also been available for patients with renal anemia in the pre-dialysis period and for those with a failing kidney allograft. Although epoetin treatment did not accelerate the worsening of native kidney function or allograft function, intensified antihypertensive treatment was required in kidney graft recipients. In patients on peritoneal dialysis, hypervolemia had a greater effect on hypertension than did epoetin treatment. Epoetin resistance was connected with C-reactive peptide cryptorchidism, intact parathyroid hormone, and treatment with angiotensin-converting enzyme inhibitors. In hemodialysis patients, lower doses of epoetin were required for patients receiving low molecular heparin and those with lower iPTH. Epoetin alpha, epoetin beta and epoetin omega seemed to be effective and safe in the treatment of renal anemia. In the past 2 years, epoetins were administered to hemodialysis patients only intravenously.