EPO or erythropoietin is a hormone that is injected into people who have anaemia or a low red blood count so that they can make more red blood cells. People who have kidney disease often develop anaemia since EPO is made almost exclusively by the kidneys. Prior to the development of a synthetic version of EPO which can be injected into patients, people with kidney diseases had to receive blood transfusions in order to combat their anaemia. Synthetic EPO is called recombinant human erythropoietin and is virtually identical to the natural hormone produced by a human being.
Kidney disease patients are injected intravenously or subcutaneously (under the skin) with EPO during dialysis. Dialysis is a process by which the blood is filtered to remove waste products. EPO can be given by the nurse or patients may learn how to inject themselves. EPO injections are given until the person no longer needs dialysis or is able to acquire a new kidney which will then be able to produce natural EPO.
The cost of an EPO injection is high although it does depend on how much EPO the patient needs. According to the National Kidney Foundation, it is estimated that the annual cost of EPO is about £3,250, although Medicare does pay part of the costs for those patients on dialysis. Insurance companies may reimburse part of the costs.
Patients with a hematocrit or red blood count of less than 30 per cent require EPO shots and the dosage varies. According to the National Kidney Foundation, most patients require between 25 to 125 Units of EPO per kilogram (0.998kg.) of body weight, three times a week. The dosage is often reduced when the red blood cell count becomes stable but can be increased again if the hematocrit dips.
EPO shots made an illegal entry into the world of sports when athletes discovered that by injecting themselves with this substance they could increase their red blood cell count. This increase in red blood cells or blood doping can improve an athlete's performance tremendously especially during sports that require a lot of stamina. It is difficult to test whether an athlete has been injected with EPO so sports governing agencies now check to see whether an athlete's hematocrit is too high. This gives some indication that the athlete might have participated in blood doping.