End-stage renal disease is fraught with a myriad of attending side problems, not the least of which is severe anemia. Almost all kidney failure patients have erythopoietin (“EPO”) injected into their blood lines during the dialysis run. EPO is a recombinant human DNA product that fools the body into creating more red blood cells in the bone marrow. It’s one of those incredibly expensive wonder drugs, but as it turns out, may not be so wonderful after all.
A recent Correction of Hemoglobin and Outcomes in Renal Insufficiency (CHOIR) study indicates that patients using erythopoietin outside of the recommended dosage levels have a higher number of deaths, strokes, heart attacks and hospitalization due to congestive heart failure. The study used chronic kidney disease patients, not dialysis patients, but the results would seem to transfer across the patient universes.
From the study:
“The study was conducted to understand whether anemic patients with chronic kidney disease not on dialysis, treated with Procrit (Epoetin alfa) to an investigational target hemoglobin level of 13.5 grams per deciliter of blood (g/dL), had improved mortality and specific cardiovascular outcomes compared to patients treated to a target hemoglobin level of 11.3 g/dL.”
In my case, my hemoglobin level fluctuates between 11.3 and 11.8 g/dL with massive injections of EPO twice a week, well within the recommended dosage level to attain a level between 10 and 12 g/dL. Problem is that I feel an order of magnitude better with a hemoglobin level of 13 compared to a hemoglobin level of 12.
Well, like Hunter said, “if the thunder don’t get you, then the lightning will.”
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