Effect of Subcutaneous and Intraperitoneal Administration of Recombinant Human Erythropoietin on Blood Pressure and Vasoactive Hormones in Patients on Continuous Ambulatory Peritoneal Dialysis

Nephron ◽  
1991 ◽  
Vol 57 (4) ◽  
pp. 394-400 ◽  
Author(s):  
Kar Neng Lai ◽  
Siu Fai Lui ◽  
Joseph C.K. Leung ◽  
Eric Law ◽  
Gary Nicholls
Keyword(s):  
Blood Pressure ◽  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Recombinant Human Erythropoietin ◽  
Intraperitoneal Administration ◽  
Human Erythropoietin ◽  
Vasoactive Hormones

Effects of Subcutaneous Recombinant Human Erythropoietin in Patients on Continuous Ambulatory Peritoneal Dialysis

1993 ◽  
Vol 13 (2_suppl) ◽  
pp. 538-540 ◽  
Author(s):  
Bruno Di Paolo ◽  
Alvaro Marini ◽  
Barbara Fiederling ◽  
Lorenzo Di Liberato ◽  
Patrizia Santarelli ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Recombinant Human Erythropoietin ◽  
Cerebral Oxygenation ◽  
Subcutaneous Administration ◽  
Well Being ◽  
Dramatic Improvement ◽  
Human Erythropoietin ◽  
Red Cell Indices ◽  
Main Components

The use of recombinant human erythropoietin (rHuEPO) has revolutionized the treatment of renelanemia, but the dose regimens, the optimal frequency, and the effects on other target organs like the central nervous systems (CNS) are still under discussion. We designed a prospective, ongoing study with 10 stable continuous ambulatory peritoneal dialysis (CAPO) patients (6 males, 4 females; mean age 64.4±7.8 years), with a pretreatment hemoglobin (Hb) <7.0 901. and requiring regular blood transfusions. Seven patients were treated with 4000 U rHuEPO once weekly (Eritrogen, Boehringer Mannhelm), 2 patients received 4000 U every 5 and 8 days, and the last one 4000 U every 10 days. The target hematocrit was 33% and Hb 10.0 g%. The CNS activity was recorded as visual (YEP), brainstem (BAER), and somatosensory (SEP)-evoked potentials. The mean Hb concentration Increased from 6.9± 1.2g% to 10.3± 1.6 g% (p<0.001) over 8 weaks. There were no significant changes In urea, creatinine, and potassium levels, and urine output. rHuEPO Induced a decrease In latency of P100 YEP, In the four main components of BAER, and In the P27–N35 Intertime of SEP. Parallel to the Improvement of red cell Indices, patients experienced a dramatic Improvement In well-being. The subcutaneous administration of a single vial of rHuEPO Is safe, convenient, and Inexpensive In CAPO. The role of rHuEPO treatment In Improving the electro-physiological brain function In uremic and anemic patients remains to be studied and may not necessarily be based on Improved cerebral oxygenation.

Intraperitoneal Administration of Recombinant Human Erythropoietin in Uremic Animals

1988 ◽  
Vol 8 (4) ◽  
pp. 249-252 ◽  
Author(s):  
Joanne M. Bargman ◽  
Andre Breborowicz ◽  
Helen Rodela ◽  
Kostas Sombolos ◽  
Dimitrios G. Oreopoulos
Keyword(s):  
Peritoneal Dialysis ◽  
End Stage Renal Disease ◽  
Recombinant Human Erythropoietin ◽  
Dialysis Patient ◽  
Intraperitoneal Administration ◽  
Peritoneal Dialysis Patient ◽  
Human Erythropoietin ◽  
Stage Renal Disease ◽  
Almost All ◽  
End Stage

Previous protocols of administration of recombinant human erythropoietin to patients with end-stage renal disease have been by the i.v. route. Because this method would be impractical for the continuous ambulatory peritoneal dialysis patient, we designed an i.p. dosing protocol in uremic rabbits to examine whether significant amounts of this hormone could be absorbed from the peritoneal cavity. Our results demonstrate that almost all of the erythropoietin is absorbed (or adsorbed) during a prolonged dwell when administered undiluted by dialysate.

Subcutaneous Recombinant Human Erythropoietin in Hemodialysis and Continuous Ambulatory Peritoneal Dialysis

1993 ◽  
Vol 13 (2_suppl) ◽  
pp. 541-543 ◽  
Author(s):  
Maria João Pais ◽  
Augusta Gaspar ◽  
Alice Santana ◽  
Margarida Bruges ◽  
Jacinto Simões
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Recombinant Human Erythropoietin ◽  
Low Dose ◽  
Group Iii ◽  
Human Erythropoietin ◽  
Group I ◽  
Starting Dose ◽  
The Mean ◽  
Mean Time

We compared the effect of twice weekly subcutaneous recombinant human erythropoietin (SC rHuEPO) In two groups of patients treated with a starting dose of 80 U/kg body weight/week: group I, 7 hemodialysis (HD) patients; group II, 8 continuous ambulatory peritoneal dialysis (CAPD) patients. In a third group (group III) of 4 patients transferred from HD to CAPD with anemia previously corrected with Intravenous (IV) rHuEPO, we studied the changes In the maintenance SC dose to maintain the same hemoglobin. In groups I and II the mean SC doses required to correct anemia and to maintain hemoglobin/hematocrit levels were similar; the mean time for the correction of anemia was significantly longer In HD patients (p=0.032). In group III the maintenance SC rHuEPO does was reduced to more than 50% at 12 weeks of CAPD. Subcutaneous rHuEPO Is effective In reversing anemia in HD and CAPD patients, but It takes longer to correct anemia In HD with the same initial SC rHuEPO low dose. CAPD patients need lower doses of SC rHuEPO than HD patients in IV therapy to maintain the same hemoglobin levels.

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