A Real-world Longitudinal Study of Anemia Management in Non-dialysis-dependent Chronic Kidney Disease Patients: a Multinational Analysis of CKDopps

Overview

Journal Sci Rep

Specialty Science

Date 2021 Jan 20

PMID 33469061

Citations 19

Authors

Marcelo Barreto Lopes

Charlotte Tu

Jarcy Zee

Murilo Guedes

Ronald L Pisoni

Bruce M Robinson

Bryce Foote

Katarina Hedman

Glen James

Antonio Alberto Lopes

Ziad Massy

Helmut Reichel

James Sloand

Sandra Waechter

Michelle M Y Wong

Roberto Pecoits-Filho

Affiliations

Soon will be listed here.

Abstract

Previously lacking in the literature, we describe longitudinal patterns of anemia prescriptions for non-dialysis-dependent chronic kidney disease (NDD-CKD) patients under nephrologist care. We analyzed data from 2818 Stage 3-5 NDD-CKD patients from Brazil, Germany, and the US, naïve to anemia medications (oral iron, intravenous [IV] iron, or erythropoiesis stimulating agent [ESA]) at enrollment in the CKDopps. We report the cumulative incidence function (CIF) of medication initiation stratified by baseline characteristics. Even in patients with hemoglobin (Hb) < 10 g/dL, the CIF at 12 months for any anemia medication was 40%, and 28% for ESAs. Patients with TSAT < 20% had a CIF of 26% and 6% for oral and IV iron, respectively. Heart failure was associated with earlier initiation of anemia medications. IV iron was prescribed to < 10% of patients with iron deficiency. Only 40% of patients with Hb < 10 g/dL received any anemia medication within a year. Discontinuation of anemia treatment was very common. Anemia treatment is initiated in a limited number of NDD-CKD patients, even in those with guideline-based indications to treat. Hemoglobin trajectory and a history of heart failure appear to guide treatment start. These results support the concept that anemia is sub-optimally managed among NDD-CKD patients in the real-world setting.

Citing Articles

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