Name of the Procedure:

Injection, epoetin alfa-epbx, biosimilar, (Retacrit) (for ESRD on Dialysis), 100 units (Q5105)

Summary

In simple terms, this procedure involves giving an injection of a medication called Retacrit, which is a biosimilar to epoetin alfa. This drug helps treat anemia (low red blood cell count) in patients with End-Stage Renal Disease (ESRD) who are undergoing dialysis.

Purpose

Medical Conditions or Problems:

• Anemia in patients with End-Stage Renal Disease (ESRD) on dialysis.

Goals or Expected Outcomes:

• Increase red blood cell count.
• Reduce symptoms of anemia such as fatigue and weakness.
• Improve quality of life for patients on dialysis.

Indications

Specific Symptoms or Conditions:

• Chronic anemia associated with ESRD.
• Symptoms such as persistent tiredness, paleness, shortness of breath, and weakness.

Patient Criteria:

• Diagnosed with ESRD and currently on dialysis.
• Documented anemia requiring treatment.

Preparation

Pre-Procedure Instructions:

• No specific fasting required.
• Monitor and adjust current medications as advised by the healthcare provider.
• Routine blood tests to evaluate hemoglobin levels and iron status.

Procedure Description

Step-by-Step Process:

1. The patient will be seated comfortably, often during a dialysis session.
2. A healthcare provider will clean the injection site, usually the arm.
3. Retacrit is drawn into a syringe.
4. The provider administers the injection subcutaneously (under the skin) or intravenously (into the vein).

5. The site is observed briefly for any immediate reactions.

   Tools and Equipment:

   • Sterile syringe and needle.
   • Alcohol swabs.
   • Retacrit medication vial.

Anesthesia or Sedation:

• Not typically required for this injection.

Duration

• The actual injection takes only a few minutes.

Setting

• Often performed in a dialysis clinic or outpatient healthcare facility.

Personnel

• Dialysis nurse or healthcare professional trained in administering subcutaneous or intravenous injections.

Risks and Complications

Common Risks:

• Pain or discomfort at the injection site.
• Mild headache or dizziness.

Rare Complications:

• Allergic reactions such as rash, itching, or swelling.
• Increased blood pressure.
• Thrombosis (blood clots).

Management:

• Monitor and promptly treat any signs of allergic reaction.
• Regular monitoring of blood pressure.
• Follow-up assessments and adjustments of dosage if required.

Benefits

Expected Benefits:

• Improvement in anemia-related symptoms.
• Enhanced ability to perform daily activities.
• Overall betterment in health and well-being.

Realization:

• Benefits often start to show within a few weeks of consistent treatment.

Recovery

Post-Procedure Care:

• Monitor the injection site for signs of infection or adverse reactions.
• Follow a balanced diet and stay hydrated.

Recovery Time:

• Minimal to no downtime; patients can usually resume normal activities immediately.

Restrictions or Follow-Up:

• Regular follow-up appointments to monitor hemoglobin levels and adjust dosage as necessary.

Alternatives

Other Treatment Options:

• Oral or intravenous iron supplements.
• Blood transfusions in severe cases.
• Use of other erythropoiesis-stimulating agents (ESAs).

Pros and Cons:

• Oral iron supplements are less invasive but may not be sufficient.
• Blood transfusions provide immediate relief but carry risks of immune reactions.
• Other ESAs may have different efficacy or side effect profiles.

Patient Experience

During the Procedure:

• The patient may feel a slight pinch during the injection.
• Generally a quick and straightforward process.

After the Procedure:

• Some mild soreness at the injection site.
• Pain management with over-the-counter pain relievers if necessary.
• Most patients continue their day with minimal discomfort.