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- Title
Anaemia management in non-dialysis chronic kidney disease (CKD) patients: a multicentre prospective study in renal clinics.
- Authors
Minutolo, Roberto; Locatelli, Francesco; Gallieni, Maurizio; Bonofiglio, Renzo; Fuiano, Giorgio; Oldrizzi, Lamberto; Conte, Giuseppe; De Nicola, Luca; Mangione, Filippo; Esposito, Pasquale; Dal Canton, Antonio
- Abstract
Background Knowledge on anaemia management in non-dialysis chronic kidney disease (ND-CKD) patients regularly followed in renal clinics is scarce although being essential to identifying areas of therapeutic improvement. Methods We prospectively evaluated anaemia management in two visits, performed 6 months apart, in 755 prevalent ND-CKD stage 3b-5 patients followed in 19 nephrology clinics from ≥6 months. Anaemia was defined as severe (Hb <11 g/dL) or mild (Hb: 11–13.5 in males and 11–12 g/dL in females); iron deficiency (ID) was defined as transferrin saturation (TSAT) <20% and/or ferritin <100 ng/mL. Primary endpoint was the change of anaemia and ID prevalence between baseline and 6-month visit. Secondary endpoint was the prevalence of clinical inertia to either ESA or iron supplementation, that is, the lack of ESA or iron prescription despite Hb <11 g/dL or ID. Results Age was 69 ± 13 years and GFR 27.5 ± 10.0 mL/min/1.73 m2; male gender, diabetes and prior cardiovascular disease were 57.2, 30.1 and 30.1%, respectively. Prevalence of severe and mild anaemia was 18.0 and 44.0% at baseline and remained unchanged at Month 6 (19.3 and 43.2%). ID was prevalent at both visits (60.1 and 60.9%). Clinical inertia to ESA was similar at baseline and at Month 6 (39.6 and 34.2%, respectively, P = 0.487) and it was less frequent than clinical inertia to iron therapy (75.7 and 72.0%, respectively). Conclusions This study shows that anaemia prevalence is unexpectedly high in the setting of tertiary nephrology care. This was due to a persistent clinical inertia in the anaemia management, remarkable for iron supplementation and less critical, but still significant, for ESA treatment.
- Subjects
ANEMIA treatment; KIDNEY diseases; HEMODIALYSIS patients; DRUG prescribing; NEPHROLOGY; LONGITUDINAL method
- Publication
Nephrology Dialysis Transplantation, 2013, Vol 28, Issue 12, p3035
- ISSN
0931-0509
- Publication type
Article