Figure 612

Correction of anemia in chronic renal failure. Anemia is a predictable complication of chronic renal failure that is due partly to reduction in erythropoietin production. Use of recombinant erythropoietin to correct the anemia in patients with chronic renal failure has become standard therapy. The rate of increase in hematocrit is dose-dependent. The indicated doses were given intravenously three times per week. Current guidelines for the initiation of intravenous therapy suggest a starting dosage of 120 to 180 U/kg/wk (typically 9000 U/wk) administered in three divided doses. Administration of erythropoietin subcutaneously has been shown to be more efficient than is intravenous administration. That is, on average, any given increment in hematocrit can be achieved with less erythropoietin when it is given subcutaneously as compared with intravenously. In adults, the subcutaneous dosage of erythropoietin is 80 to 120 U/kg/wk (typically 6000 U/wk) in two to three divided doses. rHuEpo—recombinant human erythropoietin. Data from Eschbach and coworkers [12]; with permission.

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