Erythropoietin for End-Stage Renal Disease

Currently, there are approximately 200,000 patients with end-stage renal disease in the United States who require dialysis therapy to stay alive, and dialysis is initiated in nearly 70,000 new patients each year.1 About 90 percent of patients undergoing dialysis have anemia as a result of erythropoietin deficiency. Anemia contributes substantially to morbidity and mortality among these patients, and the introduction of recombinant human erythropoietin (epoetin) therapy in 1989 significantly improved the quality of life, reduced the need for red-cell transfusions,2 and improved measures of various physiologic functions such as maximal exercise capacity and cognition. Although epoetin is expensive, costing the . . .