Q: My wife's haemoglobin (Hb) has fallen considerably. She is not able to breathe properly. She was advised iron sucrose injections. She has already taken these injections (5+1) twice through drips. But there was no improvement. Her Hb remains at 7.4. Should she take more injections or is there any other remedy to increase the haemoglobin? Kindly advise. She is a diabetic and is presently on peritoneal dialysis.

A:It is not clear as to the reason for peritoneal dialysis but I presume it is because of kidney failure secondary to diabetes. In such a disorder, anaemia is quite common. It can be corrected with recombinant epoetin alfa (Brand name: Wepox) in the following dose schedule: Cases of adults on peritoneal dialysis: 50iu/kg 2 times per week by i.v. injection. Increase if required by 25iu/kg 2 times per week every 4 weeks to achieve Hb 10-12g/dL. Maintenance: 25-50iu/kg 2 times per week in two equal doses.