A cost-effectiveness analysis of anemia screening before erythropoietin in patients with end-stage renal disease

American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
F N Hutchinson, W J Jones

Abstract

The treatment efficacy of erythropoietin (EPO) in end-stage renal disease (ESRD) can be limited by deficiencies of iron, folate, or vitamin B12, by hyperparathyroidism, or by aluminum intoxication. Since EPO costs are significant, this study attempted to determine the cost-effectiveness of performing a panel of screening tests for anemia before starting EPO. Anemia screening was performed prospectively in 48 new-onset ESRD patients at the Ralph H. Johnson Veterans Affairs Medical Center before EPO treatment was started. Serum iron, transferrin, folate, vitamin B12, parathyroid hormone, and aluminum levels were determined, and transferrin saturation (Tfsat) was calculated at the first dialysis session. At presentation for dialysis, the mean hematocrit was 0.264 +/- 0.036 and the mean blood urea nitrogen was 32 +/- 2 mmol/L. Eighteen patients (37.5%) had a serum iron level lower than 7 micromol/L, suggesting iron deficiency. Twenty-five patients (52%) had Tfsat less than 0.20, consistent with overt iron deficiency. No patient was found to be vitamin B12 deficient, to be aluminum intoxicated, or to have significant hyperparathyroidism. One patient had folate deficiency. A cost-effectiveness analysis was performed assuming that (1)...Continue Reading

Citations

Aug 9, 2006·Seminars in Dialysis·Anumeet Priyadarshi, Joseph I Shapiro
Jul 2, 2014·Seminars in Dialysis·Hesham ShabanJeffrey S Berns
Dec 9, 2010·The Journal of Toxicological Sciences·Sônia Sin Singer BrugioloMartha de Oliveira Guerra
May 9, 2001·Current Opinion in Nephrology and Hypertension·B J MannsC Donaldson
Mar 5, 2002·Seminars in Dialysis·Steven Fishbane, Richard Goldman
Sep 30, 2005·Hemodialysis International·Jeffrey S Berns, Ari Mosenkis
Dec 3, 2002·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Peter D YorginSteven R Alexander
Oct 22, 2004·Kidney International·Philip A McFarlane, Ahmed M Bayoumi
Oct 4, 2005·Advances in Chronic Kidney Disease·Larry A Greenbaum
Mar 7, 2001·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation

❮ Previous
Next ❯

Related Concepts

Related Feeds

Anemia

Anemia develops when your blood lacks enough healthy red blood cells. Anemia of inflammation (AI, also called anemia of chronic disease) is a common, typically normocytic, normochromic anemia that is caused by an underlying inflammatory disease. Here is the latest research on anemia.