Renal anaemia: recent developments and future directions for improved management.
The global burden of chronic kidney disease (CKD) and associated anaemia is substantial. With the increasing numbers of patients that are likely to be affected in the future, approaches are required to improve anaemia management without increasing the workload of renal units. Advocating early treatment may improve patient outcomes and nurses are in an ideal position to identify and manage anaemia at an early stage in patients with CKD. In addition, adopting a multidisciplinary approach, alongside nephrologists, diabetologists, cardiologists, social workers, nutritionists and pharmacists, may allow nurses to detect and treat anaemia earlier in patients with CKD. Maintaining awareness of factors associated with decreased erythropoiesis-stimulating agents (ESAs) efficacy (e.g. iron deficiency or poor nutritional status) is also important. To reduce the burden on healthcare providers, anaemia management could be simplified by extending the administration interval of ESAs. Recent studies have explored the clinical efficacy of administration of currently available agents at intervals of up to once monthly in highly selected, stable patients. The use of an ESA that can control anaemia while maintaining haemoglobin levels within guideline ranges with extended administration intervals in all patients without the need for additional screening or stepwise dose adjustments with attendant monitoring may help improve patient care while reducing the workload of healthcare providers.
Mahon
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Barts and the London NHS Trust, London, UK. Althea.Mahon@bartsandthelondon.nhs.uk
Bennett
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L
D000740:Anemia / Q000097:blood / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D004334:Drug Administration Schedule; D042241:Early Diagnosis; D005544:Forecasting; D006301:Health Services Needs and Demand; D006397:Hematinics / Q000627:therapeutic use; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications*; D024802:Nurse's Role; D009730:Nursing Assessment; D018529:Nutritional Support; D010348:Patient Care Team / Q000458:organization & administration; D010353:Patient Education as Topic; D017410:Practice Guidelines as Topic; D017749:Total Quality Management; D016896:Treatment Outcome
D006397:Hematinics; D006454:Hemoglobins