Abstract: TH-PO883
Prescribing Practices of Erythropoiesis-Stimulating Agents in Dialysis-Dependent and Nondialysis-Dependent CKD
Session Information
- Anemia and Iron Metabolism
October 24, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Anemia and Iron Metabolism
- 200 Anemia and Iron Metabolism
Authors
- Saini, Rammdeep, Dalhousie University, Halifax, Nova Scotia, Canada
- More, Keigan, Dalhousie University, Halifax, Nova Scotia, Canada
- Wilson, Jo-Anne S., Dalhousie University, Halifax, Nova Scotia, Canada
- Clark, David, Dalhousie University, Halifax, Nova Scotia, Canada
- Vinson, Amanda Jean, Dalhousie University, Halifax, Nova Scotia, Canada
- Tennankore, Karthik K., Dalhousie University, Halifax, Nova Scotia, Canada
Background
Anemia is a common complication of CKD. Erythropoiesis-stimulating agents (ESAs) have been used to treat CKD-associated anemia but are associated with increased risk of stroke, cancer progression and recurrence. There are no clear guidelines on ESA use for CKD patients with stroke, active or prior malignancy. Our objective was to assess the practice patterns and hemoglobin targets of Canadian Nephrologists and other Nephrology prescribers for ESA use in CKD patients with stroke or malignancy.
Methods
We developed a cross-sectional, online survey to assess the anemia practice patterns of Canadian nephrologists, nephrology trainees, pharmacists and nurse practitioners. Survey design was done using a modified-Delphi process. The survey was nationally disseminated to members of the Canadian Society of Nephrology from March to May, 2024. Descriptive statistics were used to characterize hemoglobin targets and perceptions of “comfort” in prescribing across practitioners.
Results
Survey response rate is 16.3% (88/540). In general CKD patients, a hemoglobin target of 95-115 g/L was most common (50.0%). In CKD patients with history of stroke, 90-105 g/L and 95-115 g/L were the most common targets (both 27.3%). In CKD patients with active or previous malignancy, 90-105 g/L was the most common target (27.3% and 25.0%, respectively). Figure-1 shows Likert scale ratings for ESA prescribing comfort in different CKD populations. Differences were observed for comfort in prescribing. Final survey results will be available in June 2024.
Conclusion
This study highlights that there are a wide range of hemoglobin targets that are used, especially among those with active or prior malignancy and informs the need for better evidence for hemoglobin targets among CKD patients with malignancy or stroke.
Figure-1: Likert Scale Ratings for ESA Prescriber Comfort in CKD Populations. Likert Rating: 1-Strongly Disagree, 2-Disagree, 3-Neither Agree nor Disagree, 4-Agree, 5-Strongly Agree. Comfort levels between general CKD patients versus other populations were compared.