It further reinforces the mantra "individualize".
Gaweda et al randomized 62 patients to either a Smart Anemia algorithm or a standardized protocol. They followed patients for 12 months. 72.5% of patients in an individualized Smart Anemia Management arm maintained their hemoglobin (Hb) between 10 to 12 g/dL compared with 61.9% in the control (standardized protocol) arm. Plus, in the individualized treatment arm there were fewer dips of Hb below 10 g/dL (11.8% vs. 24.7%) compared to the control arm.
So, lets make a dialysis unit less a sausage factory and more of a boutique, focusing on individual patients.
“You have your way. I have my way. As for the right way, the correct way,and the only way, it does not exist. (Nietzsche)
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More discussion on this issue in earlier posts...
Oct 25, 2011
The FDA emphasized that treatment of chronic kidney disease (CKD) anemia with ESA therapy should be individualized; and, the FDA pointed out, no hemoglobin target level or ESA dosing strategy should be considered ...
Sep 15, 2012
For each patient, individualize therapy - weighing risks and benefits. Establish the hemoglobin trigger - the Hb level at which the patient needs an intervention. In some patients symptomatic at 10.5 g/dL treatment needs to be ...
Mar 08, 2012
In my practice I individualize anemia management in all of my patients. I try to establish what the Hb trigger is for patients – the level of Hb where an intervention is necessary – a higher dose of epo, treatment with iron, or a ...
Aug 21, 2012
Above all: individualize therapy. Basically, try to establish for your specific patient the hemoglobin trigger i.e., the hemogloblin below which an intervention will be necessary be it starting an ESA, treating with iron or ...
