Taylor CA, Johnson CA, Zimmerman SW, Kosorok MR
Pharmacokinetics of IP EPO in CAPD patients following
instillation into a dry peritoneum
17th Annual CAPD Conference
Perit Dial Int Suppl 1
(Feb) 17:S69 1997
When EPO is given IP in PD patients, it should be given using a dry
peritoneum, to avoid the dilutional effect of the dialysate. In previous
studies, a dry period of 4 hours was used, followed by a period of 6 hours
during which an exchange was performed. In this paper, the length of the
"dry" period after EPO administration was 10 hours.
Five patients were studied. EPO 100 Units/kg was given via the PD catheter
to a dry peritoneum. The EPO area under the curve (AUC) was quite high,
higher than in a previous study where the dry period was only 4 hours,
(5319 vs. 2515 mIU/ml), and similar to the AUC when 100 IU/kg was given
subQ. However, these were non-randomized comparisons using different
patients from different studies. The authors suggest that a prolonged dry
period after EPO infusion substantially increases EPO absorption.
Comment: Obviously this study is only suggestive, as even the most
basic comparison: dry period of 4 vs. 10 hours was not done in the same
patients or in the same study. Nevertheless, it suggests that further
studies of the optimal method of IP EPO administration need to be done.
Again, to me it seems that once weekly subQ EPO should be well accepted by
almost all PD patients requiring EPO.
(John T. Daugirdas, M.D., University of Illinois at Chicago)
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17th Annual CAPD Conference
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