title: An evidence-based approach to anaemia management in predialysis chronic kidney disease.
abstract: The use of Evidence-based practice (EBP) is a decision-making process, which integrates the best available research, clinician expertise, and client characteristics, integrating quality patient care in terms of clinical outcomes and cost-effectiveness. This paper describes the application of EBP to an outpatient intravenous (IV) iron clinic for patients with predialysis chronic kidney disease (CKD). There has been an increasing focus on managing anaemia in patients with predialysis CKD. Along with the use of erythropoiesis stimulating agents, there has been an emerging interest in the use of IV iron preparations to treat anaemia in this patient population. Using EBP, we introduced a single dose preparation Ferinject to replace our original IV iron protocol using Venofer. As a test dose of Ferinject is not required, it is extremely appropriate for use in busy nurse-led IV iron clinics. Based upon the evidence generated from our initial trial of using Ferinject, and our clinical experience of using this preparation, we have now converted our IV iron protocol to Ferinject. Although the evaluation of Ferinject in our predialysis population is ongoing, we are continuing to observe the benefits of using this preparation, both in terms of patient outcome and cost-effectiveness. We consider that the use of Ferinject has reduced waiting time and waiting list pressure, and also reduced material and hospital transport costs, which are significant due to the large geographical area covered by our CKD service.
authors.affiliation: University Hospital of North Staffordshire, Hartshill, Stoke-On-Trent ST47LN, UK. Karen.Pugh-Clarke@uhns.nhs.uk
authors.forename: Karen
authors.initials: K
authors.lastname: Pugh-Clarke
authors.forename: Liz
authors.initials: L
authors.lastname: Cooper
authors.forename: June
authors.initials: J
authors.lastname: Turner
authors.forename: Jenny
authors.initials: J
authors.lastname: Fermin
mesh_terms: D000740:Anemia / Q000188:drug therapy* / Q000209:etiology; D002985:Clinical Protocols; D019317:Evidence-Based Medicine; D005290:Ferric Compounds / Q000008:administration & dosage* / Q000494:pharmacology; D006397:Hematinics / Q000008:administration & dosage* / Q000494:pharmacology; D006801:Humans; D007262:Infusions, Intravenous; D051436:Renal Insufficiency, Chronic / Q000150:complications*; D006113:United Kingdom
chemical_list: D005290:Ferric Compounds; D006397:Hematinics