NN&I - April 2010
Patient Management 24 Nephrology News & Issues April 2010www.nephronline.com min, and serum ferritin values in some or all months during the second and fourth quarters in both 2007 and 2008, and documented information on iron and ESA administration in some or all months in both 2007 and 2008. Patients whose charts did not show complete data sets in terms of their laboratory values were excluded. In 2007, iron sucrose was adminis-tered to patients who had a serum fer -ritin level between 100 and 800 ng/mL. Iron sucrose was given either as a 1g total dose divided over 10 consecutive hemodialysis sessions or as a variable, regular low-dose strategy that provid-ed 200 mg to 400 mg of iron sucrose per month. Iron was withheld if the patient's serum ferritin level exceeded 800 ng/mL. In 2008, IV iron sucrose was switched to IV ferric gluconate. Regular, low- dose IV ferric gluconate at a dosage of 62.5 mg per week was given to patients who had serum ferritin levels between 200 ng/mL and 1,200 ng/mL. Hb, Hct, serum ferritin, and TSAT values were obtained from the routine monthly lab -oratory reports. The primary end point was the change in the mean weekly dose of IV iron. Paired t tests (each with n=15) were conducted. All patients were required to have 24 months of consecutive data available. Using our records, demographic infor -mation was collected on the patients' date of birth, age, gender, and race. Diabetes status and diabetes medical history were also obtained through our database. The start date of hemodi-alysis, treatment termination date, and reason for termination were obtained from the patients' charts. All laboratory sample results and information on med -ication usage between Jan. 1, 2007, and Dec. 31, 2008, were obtained from the database. Only the first set of monthly laboratory values for each month and only those dates where medication was given to the patient were listed in the monthly data report sets.Figure 1A-B. Scatterplot diagrams showing the mean total IV iron administered and the mean ESA dose administered that is based on 15 hemodialysis patients with data available in 2007 and 2008. Each symbol type is a particular patient. The X-axis in each diagram represents 2007 data, while the Y-axis represents 2008 data. Forty-five-degree reference lines are included. 2007 Mean T otal Iron2008 Mean To tal IronFigure 1A400200 300 400 500 600300 100 200 0 2007 Mean To tal ESA2008 Mean To tal ESAFigure 1B200,00 050,000 100,000 150,000150,000 50,000 100,000 0 Figure 1A Figure 1B Patient Management_0410_8.indd 24 3/19/10 2:02:34 PM
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