NDLI: Chronic dialysis-associated anaemia in end-stage renal disease: analysis of management in two French centres.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Perrinet, M. Décaudin, B. Champs, B. Bro-des Heran, I. Urbina, M-A Lemaitre, V. Azar, R. Odou, P.
Spatial Coverage	France
Description	Country affiliation: France Author Affiliation: Perrinet M ( Pharmacy, Dunkerque General Hospital, Dunkerque, France.)
Abstract	BACKGROUND: Treatment of anaemia in renal-insufficient patients relies on the use of an erythropoiesis-stimulating agent (ESA). This study aimed to compare the impact of two different strategies of ESA prescribing on variation in haemoglobin (Hb) concentration in end-stage renal disease (ESRD) patients. METHODS: Patients with ESRD, on haemodialysis, and who had received ESA for >3 months were recruited. Different parameters were analysed: demographics, Hb level the last day of the year before dialysis, the most recent weekly ESA dose, risk factors for resistance and cost. Each institution continued its local practice for achieving the desired Hb level: increasing the ESA dose to overcome resistance in one centre and defining an upper ESA-dose limit in the other. RESULTS: A total of 185 patients were recruited. No significant differences in the biological parameters were found between the two populations. In both centres, Hb levels were comparable and mean levels exceeded 11 g/dL, despite the higher ESA doses given in one centre to achieve this target. This finding also held true for the subgroups with greater than or equal to two resistance factors. These two strategies led to large between-centre differences in treatment costs. CONCLUSION: The ESA-use strategy difference probably indicates that erythropoietin-resistance was not overcome with increased dosing. The Hb concentrations remained stable even when ESA doses were increased. On current evidence, the cheaper ESA-dose limitation strategy is preferable but randomized controlled studies, including comparisons of alternative ESA formulations are necessary.
File Format	HTM / HTML
ISSN	02694727
Issue Number	4
Volume Number	35
e-ISSN	13652710
Journal	Journal of Clinical Pharmacy and Therapeutics
Language	English
Publisher	Wiley-Blackwell
Publisher Date	2010-08-01
Publisher Place	Great Britain (UK)
Access Restriction	Subscribed
Subject Keyword	Discipline Therapeutics Discipline Pharmacology Anemia Drug Therapy Hematinics Therapeutic Use Kidney Failure, Chronic Therapy Aged Economics Etiology Darbepoetin Alfa Dose-response Relationship, Drug Drug Administration Schedule Epoetin Alfa Erythropoietin Administration & Dosage Analogs & Derivatives Female France Humans Inpatients Male Middle Aged Recombinant Proteins Renal Dialysis Adverse Effects Retrospective Studies Treatment Outcome Clinical Trial Comparative Study Journal Article Multicenter Study
Content Type	Text
Resource Type	Article
Subject	Pharmacology Pharmacology (medical)

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