Duration of dialysis and its relationship to dialysis adequacy, anemia management, and serum albumin level

Michael V. Rocco, Marjorie R. Bedinger, Roger Milam, Joel W. Greer, William M. McClellan, Diane L. Frankenfield

Research output: Contribution to journalArticle

Abstract

An analysis of the relationship between intermediate outcomes and duration of dialysis therapy in hemodialysis patients was performed by linking Health Care Financing Administration (HCFA) Core Indicators data with data obtained from HCFA form 2728 at the initiation of dialysis therapy. Patients who recently initiated hemodialysis therapy were less likely to meet Dialysis Outcomes Quality Initiative guidelines than patients with a longer duration of dialysis therapy. For both urea reduction ratio and Kt/V, odds ratios for adequate dialysis were approximately 0.20 for a duration of dialysis therapy less than 0.5 years and 0.42 to 0.63 for a duration of dialysis therapy of 0.5 to 1.0 years compared with a duration of dialysis therapy of 2.0 years or greater. For patients with a duration of dialysis therapy less than 0.5 years (compared with ≥2.0 years), the odds ratio for a hematocrit less than 28% was approximately 3.0, that for a hematocrit 33% or greater was approximately 0.6, and that for a serum albumin level of 3.5 g/dL or greater (bromcresol green method) or 3.2 g/dL or greater (bromcresol purple method) was approximately 0.4. There was a direct relationship between glomerular filtration rate at the initiation of dialysis therapy and both serum albumin and hematocrit values. Patients administered recombinant human erythropoietin (rHuEPO) predialysis were more likely to have greater hematocrits. There also was a direct relationship between hematocrit and serum albumin level. Therefore, several actionable items in regard to attentive overall medical care can result in an improvement in the percentage of patients newly started on hemodialysis therapy who meet intermediate outcomes, including the administration of rHuEPO predialysis, correction of iron deficiency, and timely placement of a permanent dialysis access.

Original languageEnglish (US)
Pages (from-to)813-823
Number of pages11
JournalAmerican Journal of Kidney Diseases
Volume38
Issue number4
StatePublished - 2001
Externally publishedYes

Fingerprint

Serum Albumin
Anemia
Dialysis
Hematocrit
Renal Dialysis
Therapeutics
Centers for Medicare and Medicaid Services (U.S.)
Erythropoietin
Bromcresol Purple
Bromcresol Green
Odds Ratio
Glomerular Filtration Rate
Urea
Iron
Guidelines

Keywords

  • Anemia
  • Erythropoietin
  • Glomerular filtration rate (GFR)
  • Hemodialysis (HD)
  • Kt/V urea
  • Serum albumin
  • Urea reduction ratio (URR)

ASJC Scopus subject areas

  • Nephrology

Cite this

Rocco, M. V., Bedinger, M. R., Milam, R., Greer, J. W., McClellan, W. M., & Frankenfield, D. L. (2001). Duration of dialysis and its relationship to dialysis adequacy, anemia management, and serum albumin level. American Journal of Kidney Diseases, 38(4), 813-823.

Duration of dialysis and its relationship to dialysis adequacy, anemia management, and serum albumin level. / Rocco, Michael V.; Bedinger, Marjorie R.; Milam, Roger; Greer, Joel W.; McClellan, William M.; Frankenfield, Diane L.

In: American Journal of Kidney Diseases, Vol. 38, No. 4, 2001, p. 813-823.

Research output: Contribution to journalArticle

Rocco, MV, Bedinger, MR, Milam, R, Greer, JW, McClellan, WM & Frankenfield, DL 2001, 'Duration of dialysis and its relationship to dialysis adequacy, anemia management, and serum albumin level', American Journal of Kidney Diseases, vol. 38, no. 4, pp. 813-823.
Rocco MV, Bedinger MR, Milam R, Greer JW, McClellan WM, Frankenfield DL. Duration of dialysis and its relationship to dialysis adequacy, anemia management, and serum albumin level. American Journal of Kidney Diseases. 2001;38(4):813-823.
Rocco, Michael V. ; Bedinger, Marjorie R. ; Milam, Roger ; Greer, Joel W. ; McClellan, William M. ; Frankenfield, Diane L. / Duration of dialysis and its relationship to dialysis adequacy, anemia management, and serum albumin level. In: American Journal of Kidney Diseases. 2001 ; Vol. 38, No. 4. pp. 813-823.
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