A real-world longitudinal study of anemia management in non-dialysis-dependent chronic kidney disease patients: a multinational analysis of CKDopps

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 anem...

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Autores principales:	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
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/4c8ee58fb7f5497aa12c649e0325f91e
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spelling	oai:doaj.org-article:4c8ee58fb7f5497aa12c649e0325f91e2021-12-02T15:23:47ZA real-world longitudinal study of anemia management in non-dialysis-dependent chronic kidney disease patients: a multinational analysis of CKDopps10.1038/s41598-020-79254-62045-2322https://doaj.org/article/4c8ee58fb7f5497aa12c649e0325f91e2021-01-01T00:00:00Zhttps://doi.org/10.1038/s41598-020-79254-6https://doaj.org/toc/2045-2322Abstract 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.Marcelo Barreto LopesCharlotte TuJarcy ZeeMurilo GuedesRonald L. PisoniBruce M. RobinsonBryce FooteKatarina HedmanGlen JamesAntonio Alberto LopesZiad MassyHelmut ReichelJames SloandSandra WaechterMichelle M. Y. WongRoberto Pecoits-FilhoNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q 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 A real-world longitudinal study of anemia management in non-dialysis-dependent chronic kidney disease patients: a multinational analysis of CKDopps
description	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.
format	article
author	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
author_facet	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
author_sort	Marcelo Barreto Lopes
title	A real-world longitudinal study of anemia management in non-dialysis-dependent chronic kidney disease patients: a multinational analysis of CKDopps
title_short	A real-world longitudinal study of anemia management in non-dialysis-dependent chronic kidney disease patients: a multinational analysis of CKDopps
title_full	A real-world longitudinal study of anemia management in non-dialysis-dependent chronic kidney disease patients: a multinational analysis of CKDopps
title_fullStr	A real-world longitudinal study of anemia management in non-dialysis-dependent chronic kidney disease patients: a multinational analysis of CKDopps
title_full_unstemmed	A real-world longitudinal study of anemia management in non-dialysis-dependent chronic kidney disease patients: a multinational analysis of CKDopps
title_sort	real-world longitudinal study of anemia management in non-dialysis-dependent chronic kidney disease patients: a multinational analysis of ckdopps
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/4c8ee58fb7f5497aa12c649e0325f91e
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A real-world longitudinal study of anemia management in non-dialysis-dependent chronic kidney disease patients: a multinational analysis of CKDopps

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