Recognize the major complications of recombinant Erythropoietin therapy

Explanation

Erythropoietin therapy is useful in patients with anemia. Especially in anemia associated with renal failure. In order for it to be useful the patient should not be Iron deficient and should have a hematocrit below 30%. It is also used in patients who are Jehovah's witnesses to build up Hb. without transfusing. It is also used in myelodysplastic syndromes for symptomatic improvement.

It can be associated with side effects of which the most important ones are:

• Hypertension: most commonly encountered.
• Iron deficiency : this should be repeatedly checked and iron saturation kept around 30%. and if oral iron does not achieve this, one may use parenteral iron.
• Thrombosis: Although not commonly seen, beware because of its consequences.
• Expensive: ~ $15,000/yr.

Inspite of its side effects, it is useful therapy when used properly.