Assessment of Erythropoiesis-Stimulating Agents for Anemia Treatment among Chronic Kidney Disease Patients: A Descriptive, Retrospective Study

Background: Renal anemia is a cause of significant morbidity, and to lesser extent mortality in patients with chronic kidney disease (CKD), the leading causes of anemia in CKD primarily are the lack of erythropoietin (EPO) and iron. Thus, effective management is possible using oral and intravenous (IV) iron preparation and genetically engineered erythropoiesis-stimulating agents such as EPO. This study aimed to assess the effect of EPO in the treatment of anemia among hemodialysis (HD) patients. Methods: A descriptive, retrospective hospital-based study was conducted in Elshaheeda Salma Hospital, Khartoum, Sudan. All patients who were anemic or had a history of anemia and undergoing HD during the period (January to June 2018) were recruited. Data were collected using a checklist and analyzed with the Statistical Package for the Social Sciences software. Results: A total of 191 anemic patients were included: 60% of them were males, and more than half of the participants were aged between 41 and 65 years. Clinically, the average duration of the dialysis among participants was 7.7 ± 5 years, and 97% of them had two dialysis sessions per week. Patients were used either IV or subcutaneous injection of EPO. 8000 IU/week were the most prescribed (52.2%) EPO dose. Whereas, only 6% and 18% were taking 100 mg IV and 150 mg oral ferrous sulfate, respectively. Furthermore, 70% of them were taking 5 mg folic acid. Moreover, the mean hemoglobin level among the participants at the end of the study was 10 ± 2.1 g/dl. Conclusion: EPO was effective in treating renal anemia in HD patients. Among the studied patients, 8000 IU/week was the most frequently used dose. The present study highlights significant low adherence to international guidelines in the management of anemia in patients on HD.