Abstract for presentation at Australia and New Zealand Society of Nephrology Annual Scientific Conference

Purpose: A simple erythropoietin and intravenous (IV) iron administration protocol was instituted in June 2004 which allows haemodialysis nurses to independently adjust erythropoietin dose and to administer iron. The results of an eighteen month survey at a small dialysis unit are presented.
Methods: Patients who became eligible for subsidised erythropoietin treatment (haemoglobin =100 g/l) were started on Erythropoietin beta in a fixed dose of 4000 units subcutaneously twice weekly. Dose was adjusted in predefined progressive steps (1,000 to 30,000 units per week in one or more doses). Haemoglobin level of <110 or >130 prompted an increase or decrease to the next step whereas levels between 110 and 130 g/l left the dose unaltered. Intravenous iron polymaltose or iron sucrose was administered at a dose of 100 mg/week or fortnightly according to protocol defined ferritin (100 to 800 µg/l) and transferrin saturation (>25,
Results: 29 patients were treated with erythropoietin over the duration of the survey ranging from 2 to 18 months. Almost 80% of patients achieved haemoglobin level between 110 and 130 g/l, at a mean erythropoietin dose of 151 (±76) units/kg/week. Mean ferritin was 353 µg/l (±212) and transferrin saturation was 25% (±9.5).
Conclusions: This survey shows that a simple protocol can be used to achieve optimal management of anaemia in a haemodialysis unit. Further, dialysis nurses are able to independently administer erythropoietin and IV iron in an effective manner.