EurekaMag.com logo
+ Site Statistics
References:
53,869,633
Abstracts:
29,686,251
+ Search Articles
+ Subscribe to Site Feeds
EurekaMag Most Shared ContentMost Shared
EurekaMag PDF Full Text ContentPDF Full Text
+ PDF Full Text
Request PDF Full TextRequest PDF Full Text
+ Follow Us
Follow on FacebookFollow on Facebook
Follow on TwitterFollow on Twitter
Follow on LinkedInFollow on LinkedIn

+ Translate

Trends in anemia management among US hemodialysis patients



Trends in anemia management among US hemodialysis patients



Journal of the American Society of Nephrology 13(5): 1288-1295



This study was undertaken to describe the relationship between hematocrit (Hct) and changes in the prescribed dose of erythropoietin (EPO) as well as selected patient and process care measures across annual national samples of hemodialysis patients from 1994 to 1998. This study uses the cohorts identified in the ESRD Core Indicators Project, random samples of 6181, 6241, 6364, 6634, and 7660 patients, stratified by ESRD Networks drawn for each year from 1994 to 1998. Patient demographic and clinical information was collected from October to December for each year. Surrogates of iron stores and patterns of iron and EPO administration were profiled from 1996 to 1998. Multivariable stepwise linear regression analyses were performed to adjust for potential confounding variables and to identify independent variables associated with Hct and EPO dose. Mean Hct and EPO dose increased each year from 31.1 +/- 5.2% to 34.1 +/- 3.7% and from 58.2 +/- 41.8 U/kg to 68.2 +/- 55.0 U/kg, respectively (P = 0.0001). Increasing Hct was positively associated with male gender, more years on dialysis, older age, higher urea reduction ratio and transferrin saturation, prescription of intravenous iron, and lower ferritin and EPO dose in multivariable models (all P = 0.0001). Male gender, older age, diabetes, higher Hct, and increasing weight, urea reduction ration, and transferrin saturation were associated with lower EPO doses (all P < 0.01). Conversely, intravenous EPO and iron were associated with higher prescribed EPO doses (all P = 0.0001). Although increasing Hct is associated with decreasing EPO dose at the patient level, the increase in Hct seen across years among the cohorts of hemodialysis patients in the United States has been associated with increasing doses of EPO at the population level.

(PDF emailed within 0-6 h: $19.90)

Accession: 011594360

Download citation: RISBibTeXText

PMID: 11961017

DOI: 10.1097/01.asn.0000013294.11876.80



Related references

Trends in Anemia Management in Hemodialysis Patients with Cancer. American Journal of Nephrology 42(3): 206-215, 2016

Trends in anemia management in US hemodialysis patients 2004-2010. Bmc Nephrology 14: 264-264, 2014

Trends in anemia management and iron repletion in hemodialysis patients A multicenter study. Journal of the American Society of Nephrology 10(PROGRAM AND ABSTR ISSUE): 261A, Sept, 1999

Trends in anemia management practices in patients receiving hemodialysis and peritoneal dialysis: a retrospective cohort analysis. American Journal of Nephrology 41(4-5): 354-361, 2016

Anemia and iron target realization in 1998: clinical management of anemia in 1,639 patients on hemodialysis. Asaio Journal 47(5): 511-515, 2001

Trends in refractory anemia in hemodialysis patients Clinical and laboratory profiles. Journal of the American Society of Nephrology 10(PROGRAM AND ABSTR ISSUE): 268A, Sept, 1999

Effect of implementation of case management on anemia management in end stage renal disease patients on hemodialysis. Journal of the American Society of Nephrology 13(Program and Abstracts Issue): 595A-596A, September, 2002

Appropriateness of anemia management in hemodialysis patients. Saudi Pharmaceutical Journal 20(1): 85-91, 2012

Anemia management in patients receiving chronic hemodialysis. Seminars in Dialysis 24(5): 597-602, 2012

Anemia management in patients with ESRD and HIV disease on hemodialysis. Journal of the American Society of Nephrology 14(Abstracts Issue): 718A-719A, November, 2003

Causes and consequences of inflammation on anemia management in hemodialysis patients. Hemodialysis International. International Symposium on Home Hemodialysis 13(2): 222-234, 2009

Management of anemia in erythropoietin-resistant hemodialysis patients. Annals of PharmacoTherapy 37(12): 1768-1773, 2003

Changing patterns of anemia management in US hemodialysis patients. American Journal of Medicine 125(9): 906-14.E9, 2012

The impact of missed treatment on the management of anemia in hemodialysis patients. Journal of the American Society of Nephrology 11(Program and Abstract Issue): 305A, September, 2000

N-acetylcysteine for the management of anemia and oxidative stress in hemodialysis patients. Nephron. Clinical Practice 116(3): C207-C216, 2011