Poor compliance with guidelines on anemia treatment in a cohort of chronic hemodialysis patients.
OBJECTIVE
Guidelines for the management of anemia and iron deficiency in chronic hemodialysis (HD) patients have been developed to standardize therapy and improve clinical outcome. The present study evaluated compliance with anemia guidelines and investigated whether differences between centers were present.


METHODS
Data on anemia management from patients in the baseline cohort of the CONTRAST study (NCT00205556) were analyzed. 598 chronic HD patients (62% male, age 63.6 ± 14.0 years) from 26 Dutch dialysis centers were included.


RESULTS
Mean hemoglobin (Hb) level was 11.9 ± 1.3 g/dl and Hb was ≥11.0 g/dl in 81% of the patients. Compliance with all anemia targets (Hb 11.0-12.0 g/dl, transferrin saturation ratio ≥20%, ferritin 100-500 ng/ml) was reached in 11.6% (95% CI 7.8-17.0) of the patients, with a wide range among centers (4-26%, adjusted for case mix, treatment-related factors and center-specific characteristics).


CONCLUSIONS
Compliance with anemia targets in stable HD patients was poor and showed a wide variation between treatment facilities.
Department of Nephrology, VU Medical Center, Amsterdam, The Netherlands. nc.vdweerd@vumc.nl
Neelke C
NC
van der Weerd
Muriel P C
MP
Grooteman
Peter J
PJ
Blankestijn
Albert H A
AH
Mazairac
Marinus A
MA
van den Dorpel
Claire H
CH
den Hoedt
Menso J
MJ
Nubé
E Lars
EL
Penne
Ingeborg
I
van der Tweel
Piet M
PM
Ter Wee
Michiel L
ML
Bots
D000368:Aged; D000740:Anemia / Q000097:blood / Q000209:etiology* / Q000628:therapy*; D003430:Cross-Sectional Studies; D004909:Erythrocyte Indices; D005260:Female; D005293:Ferritins / Q000097:blood; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D006435:Renal Dialysis / Q000009:adverse effects*; D016896:Treatment Outcome
D005293:Ferritins