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EPO and when not to administer

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  • EPO and when not to administer

    HI There,

    My father has been diagnosed with ESRD and is now on Hemodialysis. I have a question about EPO, I am getting mixed answers with regards to when we should hold it when his BP his high. Is there a specific range as to when not to be given and if so what is it also what do we do when EPO is held to avoid him from getting his blood levels to low and avoid a transfusion. Any information would greatly be appreciated!!

    Thanks
    C

  • #2
    The blood values that determine EPO dosage and dosing are based on hemoglobin (HGB) level. This level runs a fine line between anemia and excess red blood cells, which increase the risk of clotting the dialyzer filter. The range that my clinic/nephrologist has targeted for me is an HGB between 11 and 12. When I began HHD in July 2012, my HGB was a rather anemic 9. I started dosing at 5000 IU of EPO 3X per week and in a month or so my HGB rose to the desired range and then went over 12, at which point my dosing was dropped to 2X week. In the months since, I have dropped from 4000 IU to 3000 IU to 2000 IU and from 3X per week to 2X per week to 1X per week. At 1X per week and 2000IU, it's not the hassle it was at 2X or 3X per week and my HGB levels range from the low 10's to the high 11's - desireable. Influences are Iron Availability and Utilization and of course diet. I receive an IV iron bolus at every monthly clinic and my iron values (Iron Saturation - 20 to 50%, and Ferritin - 200 to 800 ng/mL) stay mostly in the acceptable ranges. This is the first instance that I read an association and means of establishing EPO levels through blood pressure.

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    • #3
      Is it possible that a dialysis patient Didnt have anemia even he is not using EPO or transfusion? I mean jut by eating the right foods....coz i have some dialysis friends here that can survive 5-9yrs without using EPO or transfusions....

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      • #4
        Epo raises your blood pressure. When I was seeing a hematologist for Epo shots prior to dialysis, they would not give me a dose if my bp was way high.

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