BACKGROUND: The diagnosis and management of anaemia in chronic kidney disease and the standards to be achieved have been detailed in the UK Renal Association Anaemia of CKD guidelines. AIMS: To determine the attainment of standards for anaemia management in the UK. METHODS: Quarterly data were obtained for haemoglobin (Hb) and factors that influence Hb from renal centres in England,Wales, Northern Ireland (EW&NI) and the Scottish Renal Registry for the incident and prevalent renal replacement therapy (RRT) cohorts for 2013. RESULTS: In the UK, in 2013,50% of patients commenced dialysis therapy with Hb 5100 g/L (median Hb 100 g/L). Of patients presenting early, 53% started dialysis with Hb 5100 g/L compared to 36% of patients presenting late. The UK median Hb of haemodialysis (HD) & peritoneal dialysis (PD) patients was 112 g/L (inter-quartile range (IQR) 103–120 g/L) and 113 g/L(IQR 103–122 g/L) respectively with 83% of patients having Hb .100 g/L for both treatment modalities. The median ferritin in HD and PD patients was 424 mg/L (IQR 280–616 mg/L) and 285 mg/L (IQR 167–473 mg/L) respectively with the majority of patients achieving ferritin 5100 mg/L.In EW&NI the median ESA dose was higher for HD than PD patients (7,333 vs. 4,000 IU/week). The percentage of patients treated with an ESA and having Hb .120 g/L ranged between centres from 3–29% for HD and from 0–26% for PD. CONCLUSIONS: There continues to be significant variation between centres in the use of iron and ESAi n order to achieve the target Hb (100–120 g/L).
BACKGROUND: The diagnosis and management of anaemia in chronic kidney disease and the standards to be achieved have been detailed in the UK Renal Association Anaemia of CKD guidelines. AIMS: To determine the attainment of standards for anaemia management in the UK. METHODS: Quarterly data were obtained for haemoglobin (Hb) and factors that influence Hb from renal centres in England,Wales, Northern Ireland (EW&NI) and the Scottish Renal Registry for the incident and prevalent renal replacement therapy (RRT) cohorts for 2013. RESULTS: In the UK, in 2013,50% of patients commenced dialysis therapy with Hb 5100 g/L (median Hb 100 g/L). Of patients presenting early, 53% started dialysis with Hb 5100 g/L compared to 36% of patients presenting late. The UK median Hb of haemodialysis (HD) & peritoneal dialysis (PD) patients was 112 g/L (inter-quartile range (IQR) 103–120 g/L) and 113 g/L(IQR 103–122 g/L) respectively with 83% of patients having Hb .100 g/L for both treatment modalities. The median ferritin in HD and PDpatients was 424 mg/L (IQR 280–616 mg/L) and 285 mg/L (IQR 167–473 mg/L) respectively with the majority of patients achieving ferritin 5100 mg/L.In EW&NI the median ESA dose was higher for HD than PDpatients (7,333 vs. 4,000 IU/week). The percentage of patients treated with an ESA and having Hb .120 g/L ranged between centres from 3–29% for HD and from 0–26% for PD. CONCLUSIONS: There continues to be significant variation between centres in the use of iron and ESAi n order to achieve the target Hb (100–120 g/L).
Authors: Jose Portolés-Pérez; Beatriz Durá-Gúrpide; José Luis Merino-Rivas; Leyre Martín-Rodriguez; Covadonga Hevia-Ojanguren; Victor Burguera-Vion; Claudia Yuste-Lozano; Luisa Sánchez-García; Jose Ramon Rodriguez-Palomares; Vicente Paraiso Journal: Clin Kidney J Date: 2019-11-22