Members of the Network’s Medical Review Board determined expected hemoglobin rates based on facility size and population mean hemoglobin of 11.0g/dL using a statistical technique and actual Network hemoglobin data (see Table of Expected Hemoglobin Rates).
The Dialysis Outcomes Quality Initiative recommends a threshold hematocrit value range of 33 to 36 percent. However, due to naturally occurring variability in hematocrit levels, it is very difficult to maintain a hematocrit within this narrow range without occasionally exceeding the target ceiling of 36.
Further, starting and stopping EPO therapy can lead to dramatic dips in hematocrit levels that may require high doses of EPO to achieve the target level again. Thus, appropriate utilization of EPO should be monitored by considering both the hemoglobin/hematocrit level and the dosage.
Below are some resources that the Network has collected and offers to facilities as tools to assist in improving the anemia management of your patients. The resources are only a small sample of what is available. The Network does not endorse the use of any one tool over another but offers them for your review and consideration.
Nephrology Pharmacy Associates Advances in Anemia Management