Renal Insufficiency
Posted by admin on August 25th, 2010This condition produces a normochromic, normocytic anemia resulting from decreased erythropoiesis and decreased RBC survival caused by decreased erythropoietin production. Serum iron stores are normal. In hemodialysis patients, injections of erythropoietin correct the anemia. In patients not being dialyzed, erythropoietin may not completely reverse the anemia because erythropoietic inhibitors can accumulate in uremia. Before erythropoietin is administered, nutritional deficiencies common in renal disease (eg, iron or folic acid deficiency) must be corrected. Erythropoietin is given IV to dialysis patients and subcutane-ously or IV to nondialysis patients with renal failure. The starting dosage is 50 to 100 u./kg 3 times/wk. The target Hct is 30% to 33%, If the target hematocrit is reached or if the hematocrit increases 4 points in 2 wk, the dosage is reduced by 25 u./kg 3 times/wk. If the hematocrii does not increase by 5 to 6 points after 8 wk of therapy and the hematocrit is below the target, the dosage is increased by 25 u./kg 3 times/wk. Further increases of 25 u./kg 3 times/wk may be made at 4- to 6-wk intervals until the desired response is attained. The maximum recommended dosage is 300 u./kg 3 times/wk.
Tags: Renal Insufficiency
