Pharmacokinetics of intravenous, subcutaneous and intraperitoneal recombinant human erythropoietin in patients on peritoneal dialysis

Abstract

The pharmacokinetics of recombinant human erythropoietin (Epo) was compared after single dose 100 U/kg intraperitoneal (IP), subcutaneous (SC) and intravenous (IV) administration in 30 noninfected patients on peritoneal dialysis. IP mode was used in 3 regimens: together with 2 liters of dialysate and into dried peritoneum with normal saline 50 ml (dwell time dry was 8 and 14 hours). Blood samples were collected during 48 hours, effluent dialysate from the first postdose exchange was selected to determine Epo recovery. Enzyme immunoassay was used for Epo analysis. Standard pharmacokinetics methods were employed for analysis of the serum Epo concentration. The area under the dosing-requirement curve for IP EPO into a dry peritoneum and bioavailability was larger than for SC administration (p<0,05). IP administration results the higher peak concentration in patients using a 14-hour dry dwell than in patients receiving EPO together with 2 liters and after SC dose, but lower than IV route. After IV administration EPO plasma concentrations half-life was least. The absorption of Epo administered by the IP route improves by extending the time of exposition in peritoneum (% dose recovered in first post-dose dialysate corresponded 76, 25,6 and 11,2 accordingly). In conclusion, the pharmacokinetics of Epo in a dry peritoneum suggests that this route may have potential clinical benefit.