View K-DOQI 2007 Update to Anemia in Chronic Kidney Disease: 2007 Update of Hemoglobin Target. [PDF, 1.9M]
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).
Use this link to access the MRB position statement:
- In response to the FDA Black Box warning regarding use of ESAs, The Renal Network's Medical Review Board reassesses anemia management goals. (6/2007)
The Following Charts offer an overview of Network outcomes:
- Hemodialysis Anemia Rates for Selected Collection Periods (2008) [PDF, 699KB]
- Peritoneal Dialysis Anemia Rates for Selected Collection Periods (2008) [PDF, 41KB]
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.
- 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]
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]