| Title
of the article |
Comparative mortality risk of anemia management practices in incident hemodialysis patients.
|
| Authors |
Brookhart MA, Schneeweiss S, Avorn J, Bradbury BD, Liu J, Winkelmayer WC. |
| Journal
|
JAMA. 2010 Mar 3;303(9):857-64. |
| Subject
Consultant |
P. Barany |
| Score
(1 to 3 stars) |
** |
| Comments |
This paper compares the mortality risk of different dialysis center–level patterns of anemia management. Using data from Medicare's end-stage renal disease program (1999-2007), each US dialysis center's anemia management practice were studied in 269 717 incident hemodialysis patients. Greater ESA and iron use were associated with decreased mortality risk at lower hematocrit levels, in which mortality rates are the highest. At higher hematocrit levels, the opposite was found - elevated mortality risk was associated with greater use of ESAs and iron in these patients, although the overall mortality rate was lower than in persistently anemic patients. |
