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Hemoglobin level variability in hemodialysis patients treated with epoetin-β during 1 year.
MedLine Citation:
PMID:  21888858     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Aim: This analysis was performed to assess the prevalence and the factors associated with hemoglobin (Hb) variability during treatment with erythropoiesis-stimulating agents (ESA) in France. Methods: Hb variability was evaluated in a subgroup of hemodialysis (HD) patients of the French cohort DiaNE. Eligible patients had received epoetin-β at least 6 months before entering DiaNE, 12 months during DiaNE and had no missing monthly Hb measurements. Up and down excursions (Hb variations > 1.5 g/dl with duration > 8 weeks) were assessed. Results: Of the 499 patients evaluated in this analysis, 295 (59%) had Hb levels inside the target range of 11 - 13 g/dl at baseline. The number of patients with constantly stable Hb level inside the target range decreased from baseline to 27.5% at 6 months and 10.8% at 12 months. More than 70% of patients experienced Hb variability. The number of excursions was 1.7 ± 0.8 per patient/year. The amplitude of up excursions was 2.8 ± 1.0 g/ dl with a duration of 14.7 ± 4.7 weeks. The amplitude of down excursions was 2.6 ± 0.9 g/dl with a duration of 14.5 ± 4.6 weeks. The main factors associated with Hb variability were number of epoetin-β dose changes, adverse events and iron therapy changes. Conclusion: Hb variability is frequent in French ESA-treated HD patients and closely related to practices. Further efforts are needed to improve anemia management.
Authors:
M Kessler; P Landais; P Bataille; L Yver; S Koné; S Kraemer; G Brillet; E Canivet
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical nephrology     Volume:  76     ISSN:  0301-0430     ISO Abbreviation:  Clin. Nephrol.     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-09-05     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0364441     Medline TA:  Clin Nephrol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  210-7     Citation Subset:  IM    
Affiliation:
Division of Nephrology, University Hospital of Nancy, Nancy, DIM, Necker Hospital, Paris, Division of Nephrology, Duchenne Hospital, Boulogne/mer, Division of Nephrology, Angouleme Hospital, Roche, Neuilly sur Seine, Lincoln, Boulogne-Billancourt, Division of Nephrology, Chateauroux, Hospital, and ARPDD, Reims, France.
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