State of the Art Lecture: The future of r-HuEPO

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Abstract
Since the introduction of recombinant human erythropoietin (r-HuEPO) 9 years ago, there have been tremendous physiological improvements in patients with various anaemias due to absolute and relative erythropoietin (Epo) deficiencies. However, not all patients that could benefit from r-HuEPO are being treated, not all are responding who should be responding, and most dialysis patients (who comprise the single largest group of treatment recipients) are being inadequately treated. The future of r-HuEPO will depend upon whether clinicians can optimize the use of r-HuEPO and determine what should be the optimal haematocrit. These issues will, in turn, depend upon whether three interdependent variables are addressed: the need for more scientific studies to evaluate various aspects of the use and effectiveness of r-HuEPO; the need for physician education to better understand the role of r-HuEPO in optimizing health in patients with anaemia in chronic renal failure and in the anaemia of chronic disease; and the need for less costly r-HuEPO therapy so that more patients can be treated and receive optimal therapy. Better use of r-HuEPO could result in significantly improved morbidity and perhaps improved survival of patients with Epo-deficient anemias.