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Abstract: TH-PO962

Contemporary Treatment Patterns of Clinically Meaningful Anemia Among Non-Dialysis-Dependent CKD Patients in the United States

Session Information

Category: Anemia and Iron Metabolism

  • 200 Anemia and Iron Metabolism

Authors

  • Ma, Junjie, Amgen, Inc, Thousand Oaks, California, United States
  • Saleem, Najma, Amgen, Inc, Thousand Oaks, California, United States
  • Moore, Carol, Amgen, Inc, Thousand Oaks, California, United States
  • Duan, Yinkang, SimulStat Inc, Solana Beach, California, United States
  • Jaramillo, Renee, SimulStat Inc, Solana Beach, California, United States
  • Toto, Robert D., The University of Texas Southwestern Medical Center, Dallas, Texas, United States
  • Weir, Matthew R., University of Maryland School of Medicine, Baltimore, Maryland, United States
  • Berns, Jeffrey S., University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States
  • Lafayette, Richard A., Stanford University, Stanford, California, United States
  • Petersen, Jeffrey, Amgen, Inc, Thousand Oaks, California, United States
Background

Anemia is a common complication in non-dialysis dependent chronic kidney disease (NDD-CKD) patients, and the appropriate management of anemia is important. This study aimed to describe the treatment patterns of clinically meaningful anemia in line with the KDIGO guidelines [90-day average hemoglobin (Hb) level ≤ 10g/dL after the first date of Hb < 12 g/dL following CKD diagnosis] and the characteristics of NDD-CKD patients with clinically meaningful anemia using Optum Electronic Health Records (EHR) database in the United States (US).

Methods

The data source was Optum EHR which had 73 million patients with at least 1 year of data available from January 1, 2015 to December 31, 2021. NDD CKD patients with anemia (≥ 3 eGFR results <60 mL/min/1.73 m2 on separate dates) were included in the analysis. Among those patients, the treatment patterns of anemia were described, including the use of erythropoiesis-stimulating agents (ESA), intravenous (IV) iron, and red blood cell (RBC) transfusion.

Results

The study included 14,922 NDD-CKD patients with clinically meaningful anemia. 46.3% were men, mean age was 73.8 ± 10.3 years. Comorbidities were common, with hypertension in 74.1%, peripheral vascular disease in 24.2%, and coronary artery disease in 27.2%. The average baseline eGFR was 44.3 ± 12.8 mL/min/1.73m2. The average baseline Hb level was 9.2 ± 0.6 g/dL. 96.3% had average baseline Hb between 8.0g/dL to 9.9g/dL, 3.7% in the range of 6.5 g/dl to 7.9g/dl, and 0.1% below < 6.5 g/dL.
In this study, IV iron was prescribed to 18.4%, RBC transfusion to 24.6%, and ESAs to 4.8% as first anemia treatment. Throughout the study period, 24.9%, 33.1% and 9.5% of NDD CKD patients received one or more prescriptions of IV iron, RBC transfusion, and ESAs. However, 52.2% did not receive any prescription of IV iron, RBC transfusion, or ESAs after anemia diagnosis.

Conclusion

A substantial proportion of contemporary NDD-CKD patients with clinically meaningful anemia in the US were not receiving treatment. Blood transfusions were prescribed in more than 20% of patients as the first anemia treatment which potentially may be avoidable.

Funding

  • Commercial Support – Amgen