IS IT TIME TO RECONSIDER SUBCUTANEOUS ADMINISTRATION OF EPOETIN

摘要: Anemia treatment in nondialysis chronic kidney disease (ND-CKD) and dialysis CKD patients (D-CKD) has been recently scrutinized the literature by lay press. New evidence suggests that receiving epoetin achieving higher hemoglobin have a risk of death cardiovascular complications. Data from Centers for Medicare & Medicaid Services demonstrate upward spiraling costs injectables, especially epoetin, care patients. There is considerable favoring use subcutaneous administration compared to intravenous route hemodialysis Evidence clearly shows achieves target level at lower administered dose. Thus, same clinical effect can be achieved cost. Despite economic evidentiary justifications adoption this strategy limited, United States. Reasons include: inflexibility providers because reduced profitability, claims oppose pain site injection, concerns regarding pure red cell aplasia associated with administration, greater cycling route. In article, advantages disadvantages are reviewed.