Table 3.

Critical elements in the discontinuation and reduction protocols that changed as a result of CMS regulations implemented on April 1, 2006

Discontinuation ProtocolReduction Protocol
When Hgb ≥13 g/dl, discontinue EPOWhen Hgb >13 g/dl, decrease EPO immediately by 25%.
• Resume EPO with a 25% dose reduction when Hgb reaches <12.5 g/dl• If the last Hgb of the prior month ≥13 g/dl, decrease EPO by 75% on the 1st of the next month.
When Hgb ≥15 g/dl, discontinue EPO.
• Resume when Hgb <13 g/dl with a 25% dose reduction.
Maximum EPO dose = 900 units/kg per wkMaximum EPO dose = 500,000 units/month and 900 units/kg per wk