Clinical application of recombinant erythropoietin in predialysis renal failure

The benefits of EPO treatment, including improved exercise tolerance, amelioration of lassitude and fatigue, improved cognitive function, and enhanced quality of life in general, can be extended to symptomatic anemic chronic renal failure patients before their need for dialysis treatment. The favorable pharmacokinetics and erythropoietic response with weekly subcutaneous dosing of EPO make this treatment suitable and convenient for patients and health care providers alike. EPO treatment can be provided without undue concern about accelerating the deterioration of renal function, but patients require frequent follow-up and close monitoring while treatment is initiated and adjusted over the first 3 to 6 months, in order to promptly detect and treat any adverse reaction or failure to respond.