Optimal and continuous anaemia control in a cohort of dialysis patients in Switzerland
Guidelines for the management of anaemia in patients with chronic kidney disease (CKD) recommend a minimal haemoglobin (Hb) target of 11 g/dL. Recent surveys indicate that this requirement is not met in many patients in Europe.
In most studies, Hb is only assessed over a short-termperiod. The aim of this study was to examine the control of anaemia over a continuous long-term period in Switzerland.
Methods: A prospective multi-centre observational study was conducted in dialysed patients treated with recombinant human epoetin (EPO) beta, over a one-year follow-up period, with monthly assessments of anaemia parameters.
Results: Three hundred and fifty patients from 27 centres, representing 14% of the dialysis population in Switzerland, were included.
Mean Hb was 11.9 +/- 1.0g/dL, and remained stable over time. Eighty-five percent of the patients achieved mean Hb greater than or equal to 11g/dL.
Mean EPO dose was 155 +/- 118 IU/kg/week, being delivered mostly by subcutaneous route (64-71%). Mean serum ferritin and transferrin saturation were 435 +/- 253 ug/L and 30 +/- 11%, respectively.
At month 12, adequate iron stores were found in 72.5% of patients, whereas absolute and functional iron deficiencies were observed in only 5.1% and 17.8%, respectively. Multivariate analysis showed that diabetes unexpectedly influenced Hb towards higher levels (12.1 +/- 0.9 g/dL; p=0.02).
One year survival was significantly higher in patients with Hb greater than or equal to 11g/dL than in those with Hb <11g/dL (19.7% vs 7.3%, p = 0.006).
Conclusions: In comparison to European studies of reference, this survey shows a remarkable and continuous control of anaemia in Swiss dialysis centres.
These results were reached through moderately high EPO doses, mostly given subcutaneously, and careful iron therapy management.
Author: Claudine M Mathieu, Daniel Teta, Nathalie Loetscher, Dela Golshayan, Luca Gabutti, Denes Kiss, Pierre-Yves Martin and Michel Burnier
Credits/Source: BMC Nephrology 2008, 9:16
Published on: 2008-12-11
Copyright by the authors listed above - made available via BioMedCentral (Open Access). Please
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