Evaluation of Anemia Management in Hemodialysis Patients in Gezira Hospital, in Sudan

Anemia of kidney disease is a common but under recognized co-morbid condition that is known to place patients at greater risk of hospitalization, cognitive impairment, cardiovascular diseases and even death.

Aims: The aims of this work to investigate current practice of anemia management in hemodialysis patients and to assess the appropriateness of anemia management.

Study Design: The study was conducted in Gezira Hospital for Renal Diseases and Surgery. Data on anemia parameters, comorbidities, ESAs dosing and iron supplementation were collected. The data were collected for 6 months retrospectively from December 2005 to July 2006. Patients with ESRD undergoing hemodialysis were included. Patients were excluded if they have cancer or receiving chemotherapy or radiotherapy.

Results: Data were collected from 83 patients under hemodialysis. The base line hemoglobin levels in December 2005 revealed that of the 97% of the patients were anemic, because they had hemoglobin levels below the recommended target level (11.0 g/d1). The patients started treatment with erythropoietin (4000IU/wk) for six months, and we found that 6% of patients received regular EPO, 56.6% received it irregularly and 37.3% not received EPO, regarding intravenous iron (100 mg/wk or 100 mg/2wk), 7.2% of patients received regular intravenous iron, 48.2% received it irregularly and 44.6% of patients did not received it, Hemoglobin levels were measured in July 2006 to evaluate the effect of treatment in hemoglobin level, we found that 95% of patients were still anemic. This indicates that current treatment strategies were ineffective because the majority of patient failed to reach the recommended hemoglobin level after six months of treatment.

This study demonstrate that there is no regular periodical laboratory tests, follow up and treatment for renal anemia.