Young EW, Bloembergen WE, Woods JD, Emmert G, Port FK, Wolfe
RA, Jones CA, Held PJ
Iron use among erythropoietin-treated US hemodialysis patients
Am Soc Nephrol
J Am Soc Nephrol (abstract)
(Sep) 7:1469 1996
With the increased recognition of the importance of iron therapy to the
success of anemia treatment, it has also become clear that there is wide
physician variability in how iron management is carried out. This study
utilized the USRDS database to describe patterns of iron use in the United
States in 1993.
The USRDS DMMS-1 was a national random sample of hemodialysis patients alive
on 12/31/93. Only 57% of patients was found to have a Hct of > 30%. In
addition, 50% of patients had a transferrin saturation < 20%, and 56% of
patients had a serum ferritin of < 200 ng/ml. Among patients with Hct <
30%,
31% of patients with transferrin saturation < 20% were not being treated
with
either oral nor intravenous iron. Similarly, among patients with Hct <
30%,
30% with serum ferritin < 200 ng/ml were on neither iron treatment.
Interestingly, for patients with Hct > 30%, parenteral iron was being
administered to 29% of patients with transferrin saturation > 20%, and 35%
of
patients with serum ferritin > 200 ng/ml.
Comment: What a powerful demonstration of the misuse of iron therapy
among
hemodialysis patients in the United States. Patients who didn't need iron
were being treated intensively, patients who were iron deficient and failing
EPO therapy were not being treated with iron. The failure of anemia therapy
by nephrologists in the United States over the past 7 years is due primarily
to a poor understanding of iron management. The recent National Anemia
Cooperative Project, and the NKF-DOQI Program should both help to rectify
this situation.
(Stephen Fishbane, M.D., Winthrop University Hospital, Mineola, NY)
To go back use the BACK button on your browser.
Otherwise click on the desired link to this article below:
Am Soc Nephrol
CRF by problem area :
Anemia/Erythropoietin/Iron