Nefrología Vol. 34 Nº 1 Año 2014
Este artículo no dispone de la versión en español
Nefrologia.2014;34:96-104 | doi: 10.3265/Nefrologia.pre2013.Oct.12234

Primer Informe del Comité de Anemia en Pacientes en Hemodiálisis Crónica de la Sociedad Latinoamericana de Nefrología e Hipertensión (SLANH)

The First Report of The Latin American Society of Nephrology and Hypertension (SLANH) Anemia Committee in Chronic Hemodialysis Patients


a Division of Nephrology, University Hospital of Caracas, Caracas, Venezuela,
b School of Medicine, Panamerican University, Ciudad City, México,
c Dialysis Center Uruguayana, Montevideo, Uruguay,
d Hospital Policial Medical Complex Churruca-Visca, Buenos Aires, Argentina,
e Division of Dialysis, San José Medical Association, San José de Mayo, Uruguay,
f Rio de Janeiro State University, Rio de Janeiro, Brazil,
g Nefronosa Service SA, Buenos Aires,
h Department of Nephrology and Mineral Metabolism, Institute of Nutrition, Salvador Zubirán, Mexico City, Mexico,
i Dialysis Center Sermedial, Valparaíso, Chile,
Resumen

Antecedentes: La anemia representa una complicación frecuente en pacientes con enfermedad renal crónica. En Latinoamérica (LA) la prevalencia y características de la anemia en pacientes en hemodiálisis (HD) no ha sido bien estudiada. Objetivo: Evaluar los resultados del primer registro de anemia del Comité de Anemia de la Sociedad Latinoamericana de Nefrología e Hipertensión. Métodos: Esta es una encuesta multinacional, voluntaria, que recolectó datos sobre el tratamiento de la anemia en pacientes en HD de unidades independientes en LA entre septiembre de 2009 y marzo de 2010. Para el análisis estadístico se utilizaron los siguientes métodos: t-test, ANOVA, chi2 y el análisis de regresión logística multivariante. Resultados: La encuesta fue respondida por 134 unidades de HD de 16 países, recibiéndose datos de 9025 pacientes. Las medias ± desviación estándar de Hb, ferritina y del índice de saturación de transferrina (IST) fueron respectivamente: 10,5 ± 1,8 g/dl, 570 ± 539 µg/l y 29,8 % ± 15. Se administró agentes estimulantes de la eritropoyesis (AEE) al 84,3 % de los pacientes y hierro intravenoso (FeIV) al 68,3 %. Solamente el 32,7 % de los pacientes tuvieron una Hb blanco de 10,5-12,0 g/dl. En pacientes con Hb < 10,5 g/dl, el 85,2 % estaban recibiendo AEE y un 68 % FeIV. Las variables independientes asociadas con nivel Hb < 10,5 g/dl fueron: género femenino, IST < 25 % y edad < 50 años.  En la muestra de pacientes analizada, a pesar del amplio uso de los AEE y FeIV, casi la mitad de los pacientes no alcanzó la Hb blanco.

Abstract

Background: Anemia almost invariably occurs in patients with chronic kidney disease. Limited data are available regarding anemia management in Latin American (LA) hemodialysis (HD) patients. Objective: To evaluate the results of the first anemia survey of the Anemia Committee of the SLANH. Methods: This is a multinational, voluntary survey that collected anemia management data from adult HD patients from independent, non-chain owned HD units, between 09/2009 and 03/2010. T-test, ANOVA, chi-square test and multivariate logistic regression were used for statistical analysis. Results: The survey received responses from 134 HD units of 16 countries providing data from 9,025 patients. Mean values of Hb, ferritin, and transferrin saturation (TSAT) were 10.5±1.8g/dL, 570±539µg/l, and 29.8±15%, respectively. Only 32.7% of patients were within the Hb target of 10.5-12.0g/dL (46.3% were below and 21.1% above). Erythropoietin-stimulating agents (ESAs) were administered to 84.3% patients and 68.3% received intravenous iron (IV). Iron deficiency (TSAT≤20%) was present in 27.5% patients and among those receiving erythropoietin, 47% did not achieve Hb target. The independent variables associated with the lowest Hb level (<10.5g/dL) were: female gender, TSAT¿25% and age<50 years. Conclusions: According to these results, nearly half of LA chronic HD patients did not achieve the recommended Hb target despite wide use of ESAs and IV iron.

Key words: Survey, Hemodialysis, Latin America, Anemia
Palabras Clave: Encuesta, Hemodiálisis, Latinoamérica, Anemia
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