Abstract: SA-PO256
Evaluating Anemia of CKD in Acutely Ill Patients
Session Information
- Anemia and Iron Metabolism: Clinical
November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Anemia and Iron Metabolism
- 202 Anemia and Iron Metabolism: Clinical
Authors
- Morales Alvarez, Martha Catalina, Icahn School of Medicine at Mount Sinai Beth Israel, New York, New York, United States
- Munoz casablanca, Nitzy N., Icahn School of Medicine at Mount Sinai Beth Israel, New York, New York, United States
- James, Karen, Icahn School of Medicine at Mount Sinai Beth Israel, New York, New York, United States
- Charen, Elliot M., Icahn School of Medicine at Mount Sinai Beth Israel, New York, New York, United States
Background
Anemia of chronic kidney disease (CKD) is one of the most common long-term complications as kidney failure progresses. The pathogenesis is multifactorial, but decreased erythropoietin production has a main role in later stages of CKD. The prevalence is approximately 33-67%. Treatment options include erythropoietin stimulant agents (ESA) once iron deficiency has been treated and contraindications have been evaluated. A decreased production of red blood cells is commonly seen in acutely-ill patients. We hypothesized that CKD/ESRD patients are at higher risk of worsening anemia even with adequate hemoglobin levels on admission.
Methods
We studied 53 patients with advanced CKD or ESRD admitted to our hospital between November 2017 and January 2018. Clinical data was obtained from chart review. Data incorporated in the analysis included: hemoglobin (Hb) on admission and upon discharge, outpatient treatment of anemia, and inpatient management of anemia such as transfusion, iron supplementation and ESA. Patients with acute bleeding during hospitalization were excluded.
Results
A total of 24 patients with Hb < 10 g/dl and 29 patients with Hb >10 g/dl on admission were included in our analysis. Patients with hemoglobin >10 g/dl on admission were noted to have significantly higher decrease in hemoglobin level upon discharge compared with patients with Hb < 10 g/dl (mean change from baseline Hb 0.9 vs -0.3, p = 0.0014). One third of patients with indication for ESA and no clinical contraindications for administration received EPO inpatient, while 33% of patients that were not treated with EPO received blood products.
Conclusion
Hospitalized patients with advanced CKD or ESRD are at high risk of worsening anemia despite adequate Hb levels on admission. We suggest considering a closer surveillance of hemoglobin for potential administration of ESA in order to prevent worsening anemia.