Study: 2 Approaches for Achieving Renal Anemia KDIGO Targets

Anemia can be corrected through more extensive intravenous (IV) iron use with less erythropoiesis-stimulating agent (ESA) or with less iron but more ESA. Higher IV iron dosing may increase oxidative stress, potentiate atherogenesis and cardiovascular toxicity and increase propensity to infections. Higher ESA may result in a variety of adverse clinical outcomes, including venous thromboembolic disease, vascular access thrombosis and predisposition to malignancy. These two approaches were studied by DaVita Clinical Research in DaVita dialysis centers in Poland and Portugal to identify any differences in outcomes.

The study found that the use and dose of IV iron was 35 percent higher (with significantly lower ESA dosages) in Poland than Portugal. The Kidney Disease: Improving Global Outcomes (KDIGO) hemodialysis anemia target was achieved in patients treated by both approaches in Poland and Portugal. The dialysis centers in Poland, which provided higher doses of iron and lower doses of ESA per week, had a higher proportion of patients with high ferritin and TSAT than centers in Portugal. Further analysis will evaluate the long-term risks of hospitalizations and mortality.

For more information, read the research poster here.