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Titolo:
Subcutaneous erythropoietin results in lower dose and equivalent hematocrit levels among adult hemodialysis patients: Results from the 1998 end-stagerenal disease core indicators project
Autore:
McClellan, WM; Frankenfield, DL; Wish, JB; Rocco, MV; Johnson, CA; Owen, WF;
Indirizzi:
Emory Univ, Rollins Sch Publ Hlth, Atlanta, GA 30329 USA Emory Univ Atlanta GA USA 30329 lins Sch Publ Hlth, Atlanta, GA 30329 USA Hlth Care Financing Adm, Baltimore, MD USA Hlth Care Financing Adm Baltimore MD USA inancing Adm, Baltimore, MD USA Univ Hosp Cleveland, Div Nephrol, Cleveland, OH USA Univ Hosp Cleveland Cleveland OH USA and, Div Nephrol, Cleveland, OH USA Wake Forest Univ, Sch Med, Nephrol Sect, Winston Salem, NC USA Wake ForestUniv Winston Salem NC USA ephrol Sect, Winston Salem, NC USA Univ Wisconsin, Sch Pharm, Madison, WI USA Univ Wisconsin Madison WI USAUniv Wisconsin, Sch Pharm, Madison, WI USA Duke Univ, Med Ctr, Inst Renal Outcomes Res & Hlth Policy, Durham, NC USA Duke Univ Durham NC USA Renal Outcomes Res & Hlth Policy, Durham, NC USA
Titolo Testata:
AMERICAN JOURNAL OF KIDNEY DISEASES
fascicolo: 5, volume: 37, anno: 2001,
pagine: NIL_23 - NIL_30
SICI:
0272-6386(200105)37:5<NIL_23:SERILD>2.0.ZU;2-K
Fonte:
ISI
Lingua:
ENG
Soggetto:
RECOMBINANT-HUMAN-ERYTHROPOIETIN; MAINTENANCE HEMODIALYSIS; OUTCOME PREDICTOR; EPOETIN ALFA; ANEMIA; DIALYSIS; PAIN; HYPERPARATHYROIDISM; FAILURE; THERAPY;
Keywords:
anemia; hematocrit; hemodialysis; epoetin alfa; infusions; intravenous; injections; subcutaneous; kidney failure;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
39
Recensione:
Indirizzi per estratti:
Indirizzo: McClellan, WM Emory Univ, Rollins Sch Publ Hlth, Clifton Rd, Atlanta, GA 30329 USA Emory Univ Clifton Rd Atlanta GA USA 30329 nta, GA 30329 USA
Citazione:
W.M. McClellan et al., "Subcutaneous erythropoietin results in lower dose and equivalent hematocrit levels among adult hemodialysis patients: Results from the 1998 end-stagerenal disease core indicators project", AM J KIDNEY, 37(5), 2001, pp. NIL_23-NIL_30

Abstract

The National Kidney Foundation's Dialysis Outcome Quality Initiative (NKF-DOQI) guidelines recommend that epoetin alfa should be administered by the subcutaneous route in hemodialysis patients. We determined whether hematocrit levels in hemodialysis patients differed by route of epoetin alfa administration after controlling for demographic factors and iron status. Data were available for 7,092 of the 7,658 patients randomly chosen for inclusion in the 1997 Health Care Financing Administration Core Indicators sample. Epoetin alfa was administered to 96% of the study cohort and was administeredsubcutaneously in 10% of patients. After controlling for hematocrit, patient characteristics, adequacy of dialysis, iron status, serum albumin, postdialysis weight, and duration of dialysis, the epoetin alfa dose by the intravenous route was 193.6 units/kg/wk (95% confidence interval, 189.5 to 197.8 units/kg/wk) compared with 167.4 units/kg/wk (95% confidence interval, 153.9 to 180.8 units/kg/wk) for the subcutaneous route (P < 0.001). The mean hematocrit for the subcutaneous route was 32.7% +/- 3.4% and for the intravenous route was 33.0% +/- 3.2% (P < 0.05). Factors independently associatedwith increased hematocrit included male gander, white race, older patient age, greater number of years on dialysis, higher serum albumin concentration, higher urea reduction ratio, and percent transferrin saturation (all P <0.001). After controlling for patient factors and weekly epoetin alfa doss, there was no association between route of epoetin alfa administration andhematocrit level (P = 0.144). Patients receiving epoetin alfa by the subcutaneous route had comparable hematocrit values using a lower epoetin alfa dose than patients receiving epoetin alfa intravenously. These data support the NKF-DOQI recommendation that epoetin alfa be administered subcutaneously in long-term hemodialysis patients. (C) 2001 by the National Kidney Foundation, Inc.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 13/07/20 alle ore 06:48:32