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The effect of a-erhythropoietine administration in dialysed patients

Adrian Tanase1,2, Petru Cepoida1
1 - Public Medical-Sanitary Institution Clinical Republican Hospital; 2. State University of Medicine and Pharmacy, "Nicolae Testemitanu"


Objective of the study is the evaluation of clinical and economical efficacy of erythropoietin and blood transfusions in dialyzed population. As well known regular erythropoietin administration is very important measure in the improvement of the dialyzed patients' quality of life due to decreasing symptoms of anemia. Several meta-analyses demonstrated the positive effect of erythropoietin-stimulating agents on the longevity of dialyzed population. The present study evaluated one month a-erythropoietin (Repretine TM) administration in patients on chronic dialysis. There were studied the effects of its administration in 52 patients versus 57 patients without administration of erythropoietin. These 109 patients were selected out of 139 patients on chronic dialysis treated in the Dialysis and Transplantation Center from the Clinical Republican Hospital. In 109 studied patients the number of transfusions were 262 in the first 5 months - mean 2,4 transfusion per patient. Overall in treated groups (1st and 2nd ones - 52 patients) there were performed 58 blood transfusions and none during the treatment period. Mean hemoglobin in this group increased from 89,69+/-1,47 g/l till 92,52+/-1,86 g/l (/\ = +2,82+/-1,30 g/l). Therefore a-erythropoietin treatment excluded the need for circa 10 blood transfusions during the therapy period. In non-treated groups (3rd and 4th ones - 45 patients) earlier there were performed 98 hemotransfusions. In the same time hemoglobin values have decreased from 88,31+/-2,25 g/l (p>0,05 in comparison with the mean values in treated groups - 89,69+/-1,47 g/l) till 83,77+/-2,49 g/l (/\ = -4,53+/-1,30 g/l). Thus, after even a month of treatment with low-to-moderate doses of a-erythropoietin there is a statistically significant difference between treated and non-treated groups: 92,52+/-1,86 g/l versus 83,77+/-2,49 g/l (p<0,01). The 5th group with the anemia treated through regular blood transfusions used to have 95 blood transfusions and 31 more ones were performed during the therapy period, making 126 transfusions per 12 patients in 6 months (1,75 hemotransfusions per month) which is significantly higher. Comparison shows that the administration of a-erythropoietin (Repretine TM) leads to decreasing of anemia symptoms and amount of hemotransfusions. Regarding economical analysis taking into account even the lowest price of blood transfusion (230 USD) its costs for one dialyzed patient will be 230 x 2,4 (the mean number of transfusion per patient in our centre during the 5 months) = 552 USD. That means 552/5 (number of months) = 110,4 USD which is more than costs of 32,000 UI of a-erythropoietin needed per month (80 USD). Therefore a-erythropoietin (Repretine TM) has clinically significant positive effects even in lower than recommended doses in dialyzed patients. In the same time non-administration of erythropoietin leads to the anemia aggravation with progressively increasing frequency of blood transfusions. As well, there was demonstrated the cost efficiency of erythropoietin administration versus blood transfusions in dialyzed population.

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