Evaluation of frequency of erythropoietin use among end stage renal disease patients in Quetta, Pakistan

Objective: While treating anaemia in end stage renal disease (ESRD) patients, recombinant human erythropoietin (EpO) is the therapy of choice. However, it is rarely used in developing countries because of the financial constrains to the healthcare as well as the patient. Keeping the point of view in mind, the objective of this research was to identify the use of Epo, its frequency, and dosage in the patients of ESRD receiving continuous haemodialysis in Quetta city, Pakistan. Methods: This was a retrospective, single cantered study. The selected population was subject with ESRD and on dialysis with prolonged anaemia. All recipients of dialysis in the past one year were targeted for the study. Data of the patients regarding anaemia and the use of erythropoietin was collected through a data collection sheet. Evaluation of the bio-chemical parameters of ESRD patients on haemodialysis was also be taken into consideration. Demographics of the selected patients were recorded carefully for the evaluation and analysis. SPSS 20.0 was used for data analysis and based on the objectives; both descriptive and inferential statistics were used for data elaboration. Results: A total of 97 ESRD patients that fulfilled the inclusion criteria were enrolled. Out of the 97, (52.6%) had age of more than 47 years and the cohort was dominated by males (63, 64.9%). Seventy two patients were on EPo use with majority on dose of 10000 IU with once a week frequency. The Man Whitney U test was used to compare erythropoietin use / non use and biochemical parameters. Haemoglobin percentage was significantly associated with erythropoietin use (p<0.05). The mean rank interpretation revealed erythropoietin users significantly associated with improved haemoglobin percentage. The Kruskal Wallis test was used to compare erythropoietin usage frequency and biochemical parameters. Haemoglobin percentage was again significantly associated with erythropoietin use frequency. The Bonferroni correction revealed erythropoietin frequency of twice a week was significantly associated with improved haemoglobin percentage. Conclusion: Although the use of EPO among ESRD was reasonable, few patients were not prescribed EPo for anaemia associated with ESRD. We do understand that availability and affordability can be a major reason here; policy makers should make sure about the use of EPo because of its evidence-based advantages over other procedures.