Erythropoietin Can Be Administered During Dialysis

The pharmacokinetics of intravenous recombinant erythropoietin administered during or after dialysis were studied by multicompartmental analysis in eight patients with end-stage renal disease to determine whether significant loss of the drug occurred during the hemodialysis procedure. Each patient had five studies, one in which the erythropoietin was given near the end of a dialysis session (baseline). In the other studies, erythropoietin was administered at the beginning of hemodialysis for 4 hrs using each of four different dialysis membranes. Both two compartment and three compartment models were used. In the two compartment solutions, the mass of the exchange compartment was significantly increased in the studies done during dialysis compared with the baseline. Clearance did not change significantly among the study sessions. When a third compartment, representing the dialysis system, was added, the kinetics of the internal exchange compartment and of the dialysis system could be determined separately. At the end of 4 hrs of dialysis after the erythropoietin dose, the dialysis systems contained an average of 7% of the administered dose. It was concluded that hemodialysis immediately after erythropoietin administration does not affect the rate of erythropoietin loss, except for small losses in the dialysis system itself when it is removed at the termination of the procedure.