Dose tailoring strategies in haemodialysis patients: a discussion of case histories

Abstract

Tailoring of the epoetin dose to the needs, clinical condition and circumstances of individual patients with renal anaemia offers potential for optimizing the benefits and costs of epoetin therapy. This can be achieved through alterations to dosing frequency, administration route and/or delivery device. Two case histories are presented to illustrate dose tailoring of epoetin therapy in daily clinical practice. The first patient was a man aged 23 years with renal failure secondary to vasculitis. Haemoglobin (Hb) levels were stable during treatment with subcutaneous (s.c.) epoetin-beta. Switching to intravenous (i.v.) epoetin-beta required, after a 5 month period of complex dose adjustments, a 50% increase in the dose of epoetin-beta to maintain Hb levels. The second patient was a woman aged 50 years with diabetic nephropathy. She self-administered epoetin-beta via the Reco-Pen device to maintain stable Hb levels. Epoetin-beta is approved for administration at dosing frequencies ranging from three times weekly to once every 2 weeks, is safe and effective whether administered by the s.c. or i.v. route and is available in a range of delivery devices. Epoetin-beta therapy can be easily tailored according to the needs, preferences and circumstances of individual patients, thereby maximizing treatment outcomes.