The negative aspects of changing include the pain patients will experience with injections and the potential for non-compliance if the erythropoietin is self-administered. Therefore, the Renal Unit at Sir Charles Gairdner Hospital has decided to convert all hemodialysis patients receiving IV ESA to SC administration in the belief that this will provide a considerable cost saving. Adjustments of doses will remain with the individual caring physicians, along the lines of usual clinical practice or a 'real-life' setting. We wish however to monitor the epoetin dose changes achieved in an Australian setting to ensure that dose reductions are achieved and that this does not occur as the expense of better anemia management. We plan to monitor this through the audit process.