Audit of the Effect of Changing From Intravenous to Subcutaneous Administration of Erythropoeisis Stimulating Agents in Haemodialysis Patients

The purpose of this study is to audit the effects of changing all haemodialysis patients from intravenous to subcutaneous administration of ESA’s, to ensure that a cost-saving is achieved and that this does not occur at the expense of anaemia control. The dose changes will occur according to usual clinical care of patients and not along a protocol.

Official Title

Audit of the Effect of Changing From Intravenous to Subcutaneous Administration of Erythropoeisis Stimulating Agents in Haemodialysis Patients – Real Life Clinical Experience

Conditions

Chronic Kidney FailureAnemia

Study Type

Observational

Study Design

Natural History, Longitudinal, Defined Population, Prospective Study

Further Details

All conventional haemodialysis patients currently dialysing in the Sir Charles Gairdner Hospital (SCGH) Dialysis Programs will convert from intravenous to subcutaneous administration of ESA. Those currently on IV epoetin alfa will be converted to either SC epoetin alfa or SC epoetin beta. Those patients on IV darbepoetin alfa will convert to SC darbepoetin alfa.Conversion to SC epoeitin formulations will be based upon a 80-100% dose conversion factor, to ensure patient Hb does not fall below 11.0 g/dL and to allow estimation of the conversion factor from IV to SC in an Australian clinical practice setting. There will be no dose reduction with SC darbepoetin alfa.The ESA will continue to be administered by the dialysis nurse with the initial dosing schedule being no more frequent than once per week. If patients move between dialysis units they will remain treated with their allocated ESA.This study will follow standard clinical practice. As such, dose changes of ESA will be made by the patients’ usual treating nephrologist according to their usual practice patterns. Intravenous iron protocols currently exists in all of these dialysis units and will continue.Anaemia coordinators currently monitor haemoglobin and iron studies on all of these dialysis patients with the variables required being entered into a database. Routine unit-based quality monitoring will continue according to current practices.

Study Start

September 2006; Expected completion: April 2008

Eligibility & Criteria

• Genders Eligible for Study: Both

Inclusion Criteria:

• On haemodialysis at a Sir Charles Gairdner Hospital Unit

Total Enrolment

Contact Details

Sir Charles Gairdner Hospital, Perth, Western Australia, 6009, Australia

• Neil C Boudville, MBBS: 61893463333; Ext. 2325; nboudvil@cyllene.uwa.edu.au