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Objective: This study was aimed at evaluating the acceptability and economic impact of the utilisation of Reco-Pen, an injection pen equipped with cartridges in patients requiring treatment with recombinant human erythropoietin (rHu-EPO)., Method: A random sample of 124 patients in maintenance dialysis or in pre-dialysis were enrolled in 42 French centres in 2001. 87% of patients were in maintenance therapy and the rest in correction phase. A nurse was dedicated in each centre to educate and assist the patients during the whole study period (2 months). The economic analysis compared the treatment costs in the subgroup of 108 patients already treated at inclusion., Results: The satisfaction scores were positive in 80% of patients in terms of improved autonomy and comfort and 93% declared themselves ready to continue using the pen. After a mean 2-month period of follow up, the self-injection rates rose from 21 to 53%. ECONOMICAL SYNTHESIS: The switch to Reco-Pen of 100 patients in maintenance therapy was associated with a total savings of 22,449 Euro, decomposed as follows: 18,725 Euro corresponding to savings in rHu-EPO, 3,500 Euro corresponding to the non-reimbursed honoraria of the private nurses, and 224 Euro in productivity savings in time spent by the centres' nurses, i.e. an accumulation of 10.4 hours.

From January 1973 to March 1983, 108 IDD patients with a mean age of 46 years were accepted to the dialysis program of the Hôpital de la Pitié. Since January 1973, 67 patients have been treated by hemodialysis. Since August 1978, 38 patients have been treated by CAPD. Three patients have been treated by intermittent peritoneal dialysis. Although diabetic patients remain at a higher risk compared to patients of the same age group, very encouraging results are observed including a 75% survival rate at three years among hemodialyzed patients less than 50 years old. Since 1978, CAPD, when home dialysis was possible, was selected as a first choice treatment. Some severe peritoneal complications still jeopardize the advantages of this method. Diabetics with ESRD, even in the older age group, should not be excluded from treatment. They should be offered within an integrated program all dialysis methods and transplantation.

A study has been carried out to compare over an 18 month period the residual glomerular filtration rate (GFR) measured by the creatinine clearance in two matched groups of 25 patients with end-stage renal disease. One group was treated by continuous ambulatory peritoneal dialysis, the other one by maintenance haemodialysis. GFR was similar in both groups immediately before starting dialysis therapy, respectively 4.3 +/- 2.3 and 4.4 +/- 2.4 ml/min. From the beginning of the dialysis treatment to the eighteenth month there was a significant and progressive decrease of GFR in the group of patients treated by haemodialysis, while in the peritoneal dialysis group GFR and peritoneal clearances remained stable.