Use of 12x/month haemoglobin monitoring with a computer algorithm reduces haemoglobin variability.
BACKGROUND
Haemoglobin variability may be associated with increased death. Frequent haemoglobin monitoring may allow earlier detection of trends in haemoglobin slopes, alerting staff to intercurrent events. The more frequent haemoglobin values may provide early evidence of response to erythropoietin (EPO) doses, and allow more appropriate anaemia management. Our objective is to assess whether frequent haemoglobin monitoring data (12x/month) using a computer algorithm (AMIE, Leeds, UK) will reduce haemoglobin variability compared with 1x/month monitoring.


METHODS
We performed an observational case-control study of 44 unselected patients, comprising one dialysis facility measuring Crit-Line haemoglobin, lab haemoglobin, standard deviation of residuals as surrogate of haemoglobin variability and EPO dosing.


RESULTS
Haemoglobin variability and 'percent in target haemoglobin range' significantly improved with 12x/month haemoglobin results using a computer algorithm. There was also a non-significant trend toward for lower EPO doses.


CONCLUSIONS
Use of a computer algorithm to analyse 12x/month haemoglobin values provides early evidence of haemoglobin trends and allows more appropriate anaemia management, with decreased haemoglobin variability, lower EPO doses and more patients achieving target haemoglobin.
Ho
Warren R
WR
Baystate Medical Center, Springfield, MA, USA. warren.ho@bhs.org
Germain
Michael J
MJ
Garb
Jane
J
Picard
Sue
S
Mackie
Molly-Kate
MK
Bartlett
Cherry
C
Will
Eric J
EJ
D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D000740:Anemia / Q000097:blood* / Q000188:drug therapy / Q000209:etiology; D016022:Case-Control Studies; D002908:Chronic Disease; D004305:Dose-Response Relationship, Drug; D005260:Female; D006397:Hematinics / Q000627:therapeutic use; D006454:Hemoglobins / Q000378:metabolism*; D006801:Humans; D007674:Kidney Diseases / Q000150:complications / Q000628:therapy; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods*; D006435:Renal Dialysis; D013813:Therapy, Computer-Assisted
D006397:Hematinics; D006454:Hemoglobins