Recombinant human erythropoietin (epoetin) is the mainstay of anemia management in hemodialysis patients. Intravenous and subcutaneous routes are the most commonly used administration methods. While differences in pharmacokinetics and efficacy between the two routes have been reported, limited data are available regarding patients residing in high-altitude regions, where chronic hypoxia may alter erythropoiesis. Therefore, we compared the required epoetin dose and the incidence of adverse events of intravenous and subcutaneous administration in hemodialysis patients in the southwestern China plateau region. We conducted a multicenter, retrospective cohort study including 5896 adult patients between January 1, 2023 and December 31, 2023. After ensuring no statistical differences in baseline data through propensity score matching, we compared the epoetin dosage and adverse event incidence between the two administration routes (intravenous and subcutaneous) during one year follow-up period. The intravenous group required higher epoetin doses. In the short term, the intravenous group achieved a higher rate of hemoglobin attainment (Hb ≥ 110 g/L) than the subcutaneous group, but rates were comparable at one year. Serum potassium was lower in the subcutaneous group within one year. Adverse event incidence and hemoglobin level were similar between the two groups. For hemodialysis patients in the southwestern plateau regions of China, subcutaneous and intravenous epoetin administration show comparable efficacy, with subcutaneous therapy being more dose-efficient and potentially more practical in clinical use. Clinical trial number is not applicable.
Li et al. (Wed,) studied this question.