Abstract
Purpose
Since the Centers for Medicare & Medicaid Services implemented the End-Stage Renal
Disease Prospective Payment System, dialysis providers have increasingly focused on
balancing resource utilization and quality outcomes for the treatment of anemia in
patients undergoing peritoneal dialysis. Limited data exist regarding anemia management
outcomes for these patients in US-based dialysis centers after the implementation
of the new payment system.
Methods
This was a retrospective, observational, cohort study of stable PD patients with end-stage
renal disease who received darbepoetin alfa for anemia management over a 15-month
period (April 1, 2011–June 29, 2012). The medication was administered by staff in
the home-training unit instead of being self-administered at home. The primary end
point was mean quarterly hemoglobin (Hb) levels. Variability in Hb levels was assessed
over the 5 quarters by using repeated measures ANOVA to test for differences in the
observed mean SDs.
Findings
In the 139 adult patients on stable peritoneal dialysis and meeting the eligibility
criteria, mean (SD) Hb level by quarter was 10.8 (1.2) g/dL in quarters 2 and 3 of
2011, 10.5 (1.1) g/dL in quarter 4 of 2011, and 10.4 (1.1) g/dL in quarters 1 and
2 of 2012. Hb levels were stable (mean SDs, 0.58–0.72) over the 5 quarters of the
study. Patient compliance with attendance for all scheduled home training unit visits
was 84%.
Implications
PD patients who underwent darbepoetin alfa administration and twice-monthly laboratory
testing in the home-training unit had stable Hb levels. Despite more frequent center
visits compared with a home-administered approach, patient compliance was high.
Key words
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Article info
Publication history
Published online: September 23, 2014
Accepted:
August 20,
2014
Identification
Copyright
© 2014 Elsevier HS Journals, Inc. Published by Elsevier Inc. All rights reserved.
