The majority of patients with End Stage Kidney Disease (ESKD) receiving dialysis suffer from anaemia. The anaemia arises because ESKD patients are deficient in iron and are also deficient in erythropoietin (EPO) a hormone manufactured by the kidneys that functions to stimulate bone marrow to generate red blood cells.
Anaemia contributes greatly to the symptoms of ESKD including fatigue, shortness of breath, depression and reduced exercise tolerance. Anaemia in ESKD is usually treated with a combination of synthetic EPO and intravenous iron both of which, and EPO in particular are an expensive component of overall ESKD care. In recent years safety and financial concerns have lead to changes in prescribing patterns for both erythropoietin and iron in many countries as EPO in particular has been found to be associated with harm when used excessively. This audit will outline the current prescribing patterns of EPO and iron for the treatment of anemia of ESKD in three dialysis centers in the west of Ireland and explore how those patterns have evolved over the past three years. The cost implications of these trends will be considered and the results will also be compared to reported trends in other countries. The results of this audit will highlight any safety concerns and outline the financial implications of current prescribing patterns and trends for patients in this region of Ireland.
