ISSN 2756-3855
International Journal of Urology and Nephrology ISSN 2091-1254 Vol. 4 (4), pp. 120-127, October, 2016. © International ScholarsJournals
Full Length Research Paper
Adherence to clinical practice guidelines for anemia among Mexican chronic dialysis patients
Catarina Munguía Miranda 1, María-de-Jesús Ventura 1, Marcela Ávila-Díaz 1, María del Carmen Prado Uribe 1, Carmen Mora Villalpando 1, Begoña Ilabaca2, Héctor Hinojosa Heredia 3, Alfonso M. Cueto Manzano 4, Pedro Trinidad Ramos 5, Ramón Paniagua 1.
Unidad de Investigación Médica en Enfermedades Nefrológicas, Hospital de Especialidades, Centro Médico Nacional Siglo XXI 1, Hospital General de Zona A1 2, Hospital general de Zona 473, Departamento de Nefrología y Unidad de Trasplante del Hospital de Especialidades, CMNO 4, Hospital de Especialidades, Centro Médico Nacional, Siglo XXI 5.
Corresponding author. E- mail: [email protected]; [email protected]; Tel. +52 (55)5627-6900 (21209).
Received 09 May, 2016; Revised 24 May, 2016; Accepted 28 May, 2016; and Published 11 October, 2016
Abstract
We analyzed adherence to Clinical Practice Guidelines (CPGs) for anemia in dialysis patients, and the frequency with which the target ranges for treatment parameters were reached. A questionnaire to analyze retrospectively the adherence to CPGs for anemia was performed. Patient’s files were reviewed and extracted demographic, clinical, laboratory and treatment data. In a cohort prospective study, we made clinical measures of hemoglobin (Hb), hematocrit (Htc), iron (Fe), transferrin (TF) and transferrin saturation (TSAT). Adherence was based on frequency of biochemical evaluations and the target ranges for the variables studies in the 2008 version of the KDOQI guidelines for anemia management. 573 patients were studied, 25% of the clinical files lacked recording of Hb and Htc. Less than 10% of the patients had one or more reports of ferritin or serum iron and none had reports of TF or TSAT. Only 40% of patients were within the limits of Hb suggested by CPGs. Over 60% of the patients had TSAT normal. Our data showed low degree of adherence to CPGs for anemia. The frequency with which the target ranges were reached was far of theoretical objectives.
Key words:Anemia; Adherence; Chronic Kidney Disease; Clinical Practice Guidelines; Hemodialysis;Peritoneal Dialysis.