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Adjusting IV Iron and EPO Doses in Patients on Hemodialysis Prior to Surgery: Can We Protect Our Patients From Iron-Deficiency Anemia?
 (Vol 33/No. 4. On-line test expires: 08/31/2008)
To receive continuing education credit, you must read the information in this article and take an on-line post test and fill out an on-line program evaluation form. The certificate will then be generated for you as a .pdf file which you can print out locally on your computer.

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  AUTHOR
Kim Deaver, BSN, RN, CNN,
 Kim Deaver, BSN, RN, CNN, is Clinical Director, University of Virginia Augusta Dialysis, Fishersville, VA.
Lori Bennington, RN, CDN,
 Lori Bennington, RN, CDN, is Anemia Manager, University of Virginia Augusta Dialysis, Fishersville, VA. She is a member of the Commonwealth Chapter of ANNA.
  OUTLINE

Ongoing blood loss and iron-deficiency anemia are common problems in patients on hemodialysis; therefore, nephrology clinicians are particularly concerned with their patients who are scheduled for surgery. Surgery can cause significant blood and iron losses, thereby worsening their preexisting anemia. However, patients on hemodialysis can be effectively treated preoperatively by adjusting their continued doses of intravenous (IV) iron and recombinant human erythropoietin (EPO) therapy, based on expected blood and iron losses. This valuable strategy can help improve surgical and anemia outcomes as well as decrease EPO requirements and the need for transfusions. This article examines the use of IV iron and EPO therapy as preventive therapy for anemia in patients on hemodialysis prior to invasive surgical procedures, illustrated with an experience from a dialysis unit and patient case studies.
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  CE RELATED INFORMATION
This offering for 1.5 contact hours is being provided by the American Nephrology Nurses’ Association (ANNA), which is accredited as a provider and approver of continuing education in nursing by the American Nurses’ Credentialing Center-Commission on Accreditation (ANCCCOA). This educational activity is approved by most states and specialty organizations that recognize the ANCC-COA accreditation process. ANNA is an approved provider of continuing education in nursing by the California Board of Registered Nursing, BRN Provider No. 00910; and the Kansas State Board of Nursing, Provider No. LT0148-0738. This offering is accepted for RN and LPN relicensure in Kansas

  EDUCATIONAL OBJECTIVES

Goal:
To increase the knowledge of those caring for patients on hemodialysis about adequate dosing of iron and EPO prior to surgery.

 Objectives:
1.Examine the implications of anemia in patients on hemodialysis who are scheduled for surgery.
2.Describe key strategies to improve anemia management in presurgical patients on hemodialysis.
3. Summarize patient case studies in which IV iron and EPO doses were adjusted prior to surgery in order to improve anemia outcomes.
AUTHOR DISCLOSURE STATEMENT
Kim Deaver has no conflicts of interest to disclose.
Lori Bennington has no conflicts of interest to disclose.

 ANNA and HDCN CE POLICY STATEMENTS

The CE policy and disclosure statements of the American Nephrology Nurses' Association are given in detail on the Symposium Home Page. The CE policy statements of HDCN are listed on this page.