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Kidney Week

Abstract: TH-PO964

Red Blood Cell Transfusion Use in Dialysis-Dependent Patients with Anemia of CKD in the United States: A Systematic Literature Review

Session Information

Category: Anemia and Iron Metabolism

  • 200 Anemia and Iron Metabolism

Authors

  • Richards, Anna, GSK, Brentford, Middlesex, United Kingdom
  • Mahajan, Anadi, Bridge Medical Consulting Ltd, Richmond, London, United Kingdom
  • Gajjala, Lakshmi Ravalitha, Bridge Medical Consulting Ltd, Richmond, London, United Kingdom
  • Desai, Supriya Chetan, Bridge Medical Consulting Ltd, Richmond, London, United Kingdom
  • Kharawala, Saifuddin, Bridge Medical Consulting Ltd, Richmond, London, United Kingdom
  • Hunnicutt, Jake N., GSK, Collegeville, Pennsylvania, United States
Background

Anemia of chronic kidney disease (aCKD) occurs frequently in dialysis-dependent (DD) patients (pts). Management includes iron supplementation, erythropoiesis-stimulating agents, and when clinically indicated, red blood cell transfusions (RBCT). There are limited collated data on RBCT use in the US; thus, a systematic literature review evaluating frequency, predictive factors, complications, healthcare resource use and costs was undertaken.

Methods

A comprehensive literature search for studies published between 1980 and June 2022 was conducted in Embase, MEDLINE and gray literature sources, to identify real-world (RW) studies and randomized controlled trials (RCTs) reporting RBCT use in US DD CKD pts. Titles and abstracts were reviewed against pre-defined criteria. Results were summarized descriptively.

Results

Of 182 relevant studies identified, 37 RW studies and 22 RCTs reported data in DD CKD US pts. In RW studies, overall frequency of RBCT use ranged from 0.0–66% (n=26); for hemodialysis (HD) pts 0.0–66% (n=19); peritoneal dialysis (PD) pts 5.5–7% (n=1); and HD and PD patients 1.4–35.5% (n=4). Rates of RBCT per 100 person-years (PY) in DD CKD pts ranged from 1.1–504 (n=12); for HD pts 1.1–148.4 (n=10); PD pts 28.8–504 (n=2); and HD and PD pts 19.2–49.7(n=1). RBCT use varied by population, pt factors and study design. For the 22 RCTs (single country [n=7], multi-country [n=15]), overall frequency of RBCT use ranged from 0.7–62%; for HD pts 1.2–62% (n=11); and HD and PD pts 0.7–21.1% (n=10), comparable to RW studies. Rates of RBCT per 100 PY ranged from 3.5–10.3 among HD and PD pts (n=3); no HD only/PD only studies were found. Predictors of RBCT based on quantitative multivariable analysis were identified in 6 RW studies; 5 reported RBCT complication data; 2 HCRU data and 2 direct costs associated with RBCT use and complications.

Conclusion

RBCTs form part of aCKD management in DD CKD US pts, with higher rates in RW studies than in RCTs, although frequencies were comparable. Factors accounting for the variations in frequency, and predictive factors for RBCT use were identified. There are limited data on complications, HCRU and costs of RBCT.

Funding

  • Commercial Support – Funded by GSK (Study 218929)