Kidney Week

Abstract: TH-OR089

Contemporary Anemia Management in Peritoneal Dialysis Patients: Results from the Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS)

Session Information

• Peritoneal Dialysis
  November 02, 2017 | Location: Room 290, Morial Convention Center
  Abstract Time: 04:42 PM - 04:54 PM

Category: Dialysis

• 608 Peritoneal Dialysis

Authors

• Perlman, Rachel, University of Michigan Health Center, Ann Arbor, Michigan, United States

Rachel Perlman, MD

• Zhao, Junhui, Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States

Junhui Zhao,

• Fuller, Douglas S., Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States

Douglas S. Fuller,

• Bieber, Brian, Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States

Brian Bieber,

• Li, Yun, University of Michigan, Ann Arbor, Michigan, United States

Yun Li,

• Pisoni, Ronald L., Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States

Ronald L. Pisoni,

• Robinson, Bruce M., Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States

Bruce M. Robinson,

• Johnson, David W., Princess Alexandra Hospital, Brisbane, Queensland, Australia

David W. Johnson,

• Kawanishi, Hideki, Tsuchiya General Hospital, Hiroshima, Japan

Hideki Kawanishi,

• Davies, Simon J., University Hospital of North Midlands, Stoke-on-Trent, United Kingdom

Simon J. Davies,

• Schreiber, Martin J., DaVita HealthCare Partners Inc. , Denver, Colorado, United States

Martin J. Schreiber,

• Perl, Jeffrey, St. Michael's Hospital, Toronto, Ontario, Canada

Jeffrey Perl,

Background

Gaps in knowledge exist regarding anemia management among peritoneal dialysis (PD) patients. We sought to understand international variation in anemia management among patients receiving PD.

Methods

PDOPPS is an international prospective cohort study based on randomly selected national samples of PD patients. Hemoglobin (Hgb), TSAT, and ferritin levels, as well as erythropoiesis stimulating agent (ESA) and iron use collected between 2014-16 were compared in cross-sections of PD patients at study enrolment. Results were analysed by country: Australia and New Zealand (A/NZ), Canada, Japan, United Kingdom (UK), and United States (US).

Results

Mean Hgb ranged from 10.9-11.2 g/dL across countries (table). ESA use was higher in Japan (93%) vs. 65-71% elsewhere, with ESA type varying by country. Median epoetin dose ranged from 2500-7250 units/week. In US and Japan, 87-88% of patients had a TSAT≥20%, compared to 72-76% of patients in other countries. Ferritin >500 ng/mL was most common in US, at 60% compared to 7-35% in other countries. IV iron use was higher in US (53%) than elsewhere (5-18%).

Conclusion

In the largest international study to date of anemia and iron management in PD patients, we have demonstrated comparable Hgb levels across countries but significant variations in markers of iron adequacy and ESA and iron use. Notably, US PD patients have higher ferritin levels, iron saturation and IV iron use than other countries. Future analyses will investigate whether these differences persist after patient- and facility-level adjustments, and will evaluate associations between anemia management practices and clinical and patient-reported outcomes.

Funding

• Commercial Support – Amgen, AstraZeneca, Baxter Healthcare, Kyowa Hakko Kirin, Hexal AG, Janssen, Keryx, Proteon, Relypsa, Roche, Vifor Fresenius Medical Care Renal Pharma, ERA-EDTA, Japanese Society for PD, Association of German Nephrology Centres, Societies for Nephrology in Germany, Italy, & Spain.