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Frequency of administration of erythropoiesis-stimulating agents for the anaemia of end-stage kidney disease in dialysis patients

Hahn D, Cody JD, Hodson EM
Published Online: 
28 May 2014

Anaemia (having too few red blood cells) is a major cause of tiredness and other problems often experienced by people on dialysis. Dialysis is treatment for kidney disease using an artificial kidney machine (haemodialysis) or by exchanging fluid through a tube in the abdomen (peritoneal dialysis).

Manufactured erythropoietin (a hormone that increases red blood cell production) improves anaemia and is often prescribed for people on dialysis. Several different forms of manufactured erythropoietin that can be given less often are now available.

We looked at evidence from 33 studies that involved over 5500 people that were published before March 2013 to find out if how often erythropoietin agents are given to people who are receiving dialysis can help to improve anaemia.

We found that the newer erythropoietin agents given less often (weekly to every four weeks) resulted in similar correction of anaemia compared with older agents (given two to three times per week) for people on haemodialysis. We did not find any significant differences in side effects between the newer and older agents, but not all studies reported information on side effects.

There was not enough information about use of these agents for children or people on peritoneal dialysis to determine if less frequent administration was effective for these groups of people.

This review updates information previously published in 2002 and 2005.