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- Title
Anemia management of adult hemodialysis patients in the U.S.: Results from the 1997 ESRD Core Indicators Project.
- Authors
Frankenfield, Diane; Johnson, Curtis A.; Wish, Jay B.; Rocco, Michael V.; Madore, Francois; Owen, William F.
- Abstract
Anemia management of adult hemodialysis patients in the U.S.: Results from the 1997 ESRD Core Indicators Project. Background. The Health Care Financing Administration's End-Stage Renal Disease (ESRD) Core Indicators Project collects clinical information on prevalent adult patients receiving in-center hemodialysis (HD) care in the United States to assess the quality of care delivered. Although hematocrit values, transferrin saturations, and iron prescription practices have improved over the last five years, we sought to determine whether continued opportunities for improvement of this domain of care exist. Methods. A random sample of 7292 adult in-center HD patients was selected. Dialysis facility staff provided clinical information for the period of October through December 1996 for 6858 (94%) patients; complete laboratory information was available from 4991 (73%) returned forms. Hematocrit values, transferrin saturations, serum ferritin concentrations, epoetin alfa dosing, and iron prescriptions were abstracted from patient medical records to assess anemia management practices. Results. The mean hematocrit for this cohort was 32.6 ± 3.5%. Seventy-two percent of patients had hematocrit values> 30%. Forty-two percent had hematocrit values of 33 to 36%, and 10% were severely anemic (hematocrit <28%). Ninety-four percent of the patients received epoetin alfa intravenously (i.v.) and 6% subcutaneously. The mean weekly dose was 202.4 ± 137.2 units/kg. The mean transferrin saturation was 27.4 ± 12.6%; 73% of patients had a mean transferrin saturation ≥20%. The mean serum ferritin concentration was 386 ± 422 ng/mL; 79 and 12% of patients had a serum ferritin concentration of> 100 and> 800 ng/mL, respectively. Nine percent of the sample (N = 434) had a transferrin saturation <20% and serum ferritin concentration <100 ng/mL. Regardless of the patient's transferrin saturation, approximately three fourths of the patients received either oral or...
- Subjects
UNITED States; ANEMIA treatment; HEMODIALYSIS patients; TREATMENT of chronic kidney failure
- Publication
Kidney International, 2000, Vol 57, Issue 2, p578
- ISSN
0085-2538
- Publication type
Article
- DOI
10.1046/j.1523-1755.2000.00878.x