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Kidney Week

Abstract: PO0469

Anemia Care of Hemodialysis Patients: A National Study from Qatar

Session Information

Category: Anemia and Iron Metabolism

  • 200 Anemia and Iron Metabolism

Authors

  • Hamad, Abdullah Ibrahim, Hamad Medical Corporation, Doha, Ad Dawhah, Qatar
  • Khan, Nadiya Noor Mohammad, Hamad Medical Corporation, Doha, Ad Dawhah, Qatar
  • Ismail, Hany Ezzat, Hamad Medical Corporation, Doha, Ad Dawhah, Qatar
  • Ramadan, Fatma Ahmed, Hamad Medical Corporation, Doha, Ad Dawhah, Qatar
  • Aly, Sahar, Hamad Medical Corporation, Doha, Ad Dawhah, Qatar
  • Lonappan, Vimala K., Hamad Medical Corporation, Doha, Ad Dawhah, Qatar
  • Yasin, Fadumo Yusuf, Hamad Medical Corporation, Doha, Ad Dawhah, Qatar
  • Thomas, Mariamma, Hamad Medical Corporation, Doha, Ad Dawhah, Qatar
  • Ibrahim, Rania Abdelaziz, Hamad Medical Corporation, Doha, Ad Dawhah, Qatar
  • Al-Ali, Fadwa M., Hamad Medical Corporation, Doha, Ad Dawhah, Qatar
Background

Achieving anemia targets in dialysis patients is hard. Challenges like cost, compliance and erythropoietin stimulation agents (ESA) resistance can hamper anemia management. We established a new national anemia nurse manager model to improve care of anemia in dialysis patients in the State of Qatar. Key drivers of the new model are summerized in Figure below. We studied the effects of this program in improving anemia care in hemodialysis patients.

Methods


We did a retrospective study (IRB 01-20-158) to evaluate effectiveness of anemia nurse manager program in achieving anemia targets (percentage of patients with hemoglobin (Hg) in target (optimal range of 10-12g/dL)) and avoid extreme Hg (high (>13 g/dL) or low Hg (<9 g/dL) to avoid complications. We also studied effect of this model on ESA dosing. Our study included all adult ambulatory hemodialysis patients in the State of Qatar. Study duration was from July 2018-February 2020. Data was extracted from the Qatar national electronic medical rocord system.

Results

Our ambulatory HD patients increased from 535 to 575 during study duration. Age was 59+/-11 years with 59% male gender. Patients were mostly from the Middle East area 82% with 11% from South Asia and 5 % from East Asia. There was a significant improvement in patients with target Hg 10-12 g/dL (from 66% in July 2018 to 78% in February 2020, p=0.00001). Patients with extreme Hg were maintained at very low level throughout the study period (Hg<9 of 3.7% +/- 0.9% and Hg >13 of 4% +/- 0.7%). ESA dose was steady without much fluctuations (Darbepoietin 42.2+/-3.73 mcg/week and Mircera 149+/-18 mcg/month).

Conclusion

Our study showed that the new anemia care model improved anemia targets (Hg in range and low percentage of extreme Hg). ESA dose was steady during study period. Based on this result, we are implemnting similar models in different clinical areas in dialysis to improve patient care.

Funding

  • Government Support – Non-U.S.