Optimal and continuous anaemia control in a cohort of dialysis patients in Switzerland.

Details

Serval ID
serval:BIB_995217816DB1
Type
Article: article from journal or magazin.
Collection
Publications
Title
Optimal and continuous anaemia control in a cohort of dialysis patients in Switzerland.
Journal
Bmc Nephrology
Author(s)
Mathieu C.M., Teta D., Lötscher N., Golshayan D., Gabutti L., Kiss D., Martin P.Y., Burnier M.
ISSN
1471-2369 (Electronic)
ISSN-L
1471-2369
Publication state
Published
Issued date
2008
Volume
9
Pages
16
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: epublish
Abstract
BACKGROUND: 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-term period. 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 +/- 1.0 g/dL, and remained stable over time. Eighty-five % of the patients achieved mean Hb >or= 11 g/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 microg/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 >or= 11 g/dL than in those with Hb <11 g/dL (19.7% vs 7.3%, p = 0.006).
CONCLUSION: 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.
Keywords
Adolescent, Adult, Aged, Aged, 80 and over, Anemia/prevention & control, Cohort Studies, Comorbidity, Female, Humans, Incidence, Kidney Failure, Chronic/epidemiology, Kidney Failure, Chronic/rehabilitation, Male, Middle Aged, Quality Assurance, Health Care/methods, Renal Dialysis/methods, Renal Dialysis/statistics & numerical data, Switzerland/epidemiology, Treatment Outcome, Young Adult
Pubmed
Open Access
Yes
Create date
24/07/2013 10:26
Last modification date
16/04/2020 6:26
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