Anemia Management Practice in French Hemodialysis Centers
Journal Title: Journal of Advances in Medicine and Medical Research - Year 2015, Vol 5, Issue 11
Abstract
Objective: Evaluate the hemoglobin (Hb) target values in hemodialysis (HD) patients treated with erythropoiesis-stimulating agents (ESA). Methods: Records of anemia parameters of HD patients treated during year 2012 in 5 French dialysis centers were retrospectively analyzed. Patients were stratified into “annual Hb categories” according to their monthly mean Hb: Low Hb (< 10 g/dL), Ideal Hb (from 10 to ≤ 12 g/dL), High Hb (> 12 g/dL) if they spent ≥ 75% of time in the respective category; otherwise patients were classified as Fluctuating Hb. Results: Out of 636 evaluable patients (mean age 66.6 [SD 14.9] years; male 59.4%), 91.4% received ESA treatment and 74.2% received intravenous iron. Most patients (68.9%) belonged to the Fluctuating Hb category (Ideal 18.7%; High 9.6%; Low 2.8%). Patients in the Fluctuating category experienced more frequently ESA dose changes, transfusions, hospitalizations and co-morbidities compared with patients in other Hb categories. Multinomial logistic regression identified presence of at least one comorbidity (odds-ratio [OR]=7.6), hospitalization (OR=2.2), transfusion (OR=2.9), male gender (OR=0.6) and serum ferritin ≥500 vs. <200 µg/L (OR = 0.4) as predictors of Fluctuating vs. Ideal annual Hb category. Conclusions: Only 18.7% of patients had stable Hb levels within the target range according to French and international guidelines; most had fluctuating Hb levels and few patients had a consistently low annual Hb. These findings suggest that development and implementation of improved hematologic assessment and anemia treatment strategies are needed to minimize fluctuating Hb values in HD patients.
Authors and Affiliations
Jacques Rottembourg, Pablo Urena Torres, Hervé Le Monies De Sagazan, Khaled Sirajedine, Corinne Emery, Lorraine Zakin, Jorge Wernli, Lamine Mahi
Keywords
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- EP ID EP347078
- DOI 10.9734/BJMMR/2015/14248
- Views 58
- Downloads 0
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