Anemia Management
View K-DOQI 2007 Update to Hemoglobin Target [PDF, 1.9M]
Use this link to access the MRB position statement:
The Following Charts offer an overview of Network outcomes:
- Hemodialysis Anemia Rates for Selected Collection Periods (2006) [PDF, 14KB]
- Peritoneal Dialysis Anemia Rates for Selected Collection Periods (2006) [PDF, 14KB]
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.
K-DOQI Guidelines for Treatment of Anemia of Chronic Renal Disease: (Internet access required to view)
- Introduction: Access document
- Anemia Work-up: Access document
- Target Hematocrit/Hemoglobin: Access document
- Iron Support: Access document
- Administration of Epoetin: Access document
- Inadequate Epoetin Response: Access document
- Role of Red Blood Cell Transfusions: Access document
- Possible Adverse Effects Related to Epoetin Therapy: Access document
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.
Amgen
- Anemia Management Protocol Fundamentals [PDF, 138KB]
- Anemia Management Protocol [PDF, 213KB ]
- Anemia Management Template (Word Doc, 122KB)
- Hyporesponse and Dosing Algorithm [PDF, 20KB ]
- Anemia Management in Peritoneal Dialysis Patients [PDF, 149KB]
- Starting Dose: Based on Weight [PDF, 121KB]
- EPOGEN Dose Calculator: Dose by Weight Chart [PDF, 183KB]
- EPOGEN Dose Calculator: Dose Adjustments Chart [PDF, 306KB]
- Medical Documentation Patient Sample Chart [PDF, 112KB]
- Medical Documentation Checklist [PDF, 25KB]
Baxter
- Management of Anemia [PDF, 154KB]
- Baxter EPO Management Algorithms (Excel, 43KB)
Midwest Kidney Center
- EPOGEN Protocol [PDF, 110KB]
- EPOGEN Pathway - Hemodialysis (Excel, 33KB)
- EPOGEN Pathway - Peritoneal Dialysis (Excel, 33KB)
Nephrology Pharmacy Associates Advances in Anemia Management
- Initiation of Iron Therapy in CKD Stage 3 or 4, Advances in Anemia Management (Vol.3, No.2, 2004) [PDF, 152KB]
- Anemia Management in the United States: Is There Opportunity for Improvement? (Vol.1, No.1, 2002) [PDF, 251KB]