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dc.contributor.authorMiskulin, Dana C
dc.contributor.authorZhou, Jing
dc.contributor.authorTangri, Navdeep
dc.contributor.authorBandeen-Roche, Karen
dc.contributor.authorCook, Courtney
dc.contributor.authorEphraim, Patti L
dc.contributor.authorCrews, Deidra C
dc.contributor.authorScialla, Julia J
dc.contributor.authorSozio, Stephen M
dc.contributor.authorShafi, Tariq
dc.contributor.authorJaar, Bernard G
dc.contributor.authorBoulware, L E
dc.contributor.authorThe DEcIDE Network Patient Outcomes in End Stage Renal Disease Study Investigators
dc.date.accessioned2013-12-18T12:02:52Z
dc.date.available2013-12-18T12:02:52Z
dc.date.issued2013-12-01
dc.identifier.citationBMC Nephrology. 2013 Dec 01;14(1):264
dc.identifier.urihttp://hdl.handle.net/1993/22494
dc.description.abstractAbstract Background There have been major changes in the management of anemia in US hemodialysis patients in recent years. We sought to determine the influence of clinical trial results, safety regulations, and changes in reimbursement policy on practice. Methods We examined indicators of anemia management among incident and prevalent hemodialysis patients from a medium-sized dialysis provider over three time periods: (1) 2004 to 2006 (2) 2007 to 2009, and (3) 2010. Trends across the three time periods were compared using generalized estimating equations. Results Prior to 2007, the median proportion of patients with monthly hemoglobin >12 g/dL for patients on dialysis 0 to 3, 4 to 6 and 7 to 18 months, respectively, was 42%, 55% and 46% declined to 41%, 54%, and 40% after 2007, and declined more sharply in 2010 to 34%, 41%, and 30%. Median weekly Epoeitin alpha doses over the same periods were 18,000, 12,400, and 9,100 units before 2007; remained relatively unchanged from 2007 to 2009; and decreased sharply in the patients 3–6 and 6–18 months on dialysis to 10,200 and 7,800 units, respectively in 2010. Iron doses, serum ferritin, and transferrin saturation levels increased over time with more pronounced increases in 2010. Conclusion Modest changes in anemia management occurred between 2007 and 2009, followed by more dramatic changes in 2010. Studies are needed to examine the effects of declining erythropoietin use and hemoglobin levels and increasing intravenous iron use on quality of life, transplantation rates, infection rates and survival.
dc.rightsinfo:eu-repo/semantics/openAccess
dc.titleTrends in anemia management in US hemodialysis patients 2004--2010
dc.typeJournal Article
dc.typeinfo:eu-repo/semantics/article
dc.language.rfc3066en
dc.description.versionPeer Reviewed
dc.rights.holderDana C Miskulin et al.; licensee BioMed Central Ltd.
dc.date.updated2013-12-18T12:02:57Z
dc.identifier.doihttp://dx.doi.org/10.1186/1471-2369-14-264


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