Anaemia Management in Patients on Peritoneal Dialysis in Portugal: A Nationwide Multicenter Survey.

Introduction: The European Best Practice Guidelines for the Anaemia Management (EBPG) recently published emerged as an international standard in the management of anemia in chronic kidney disease (CKD) patients.

Objectives: To evaluate the impact of theses guidelines in the clinical practice in Portugal.

Methods: This epidemiological, multicentric and cross-sectional study included patients on peritoneal dialysis that were under erythropoietin treatment in Portugal during 2004. Etiology of CKD, prevalence and anaemia treatment, comorbidity and side effects were evaluated.

Results: 220 patients from 5 Units were evaluated. Mean haemoglobin was 12.34 g/dL and only 13,2% of patients had haemoglobin <11 g/dL. Ninety-nine percent of patients were treated with erythropoietin: 65% with beta erythropoietin (beta) and 35% with darbepoetin alfa (darbe). Subcutaneous route had been used in all cases: 5,4% with once-monthly administration (darbe), 19,55 % two times monthly (darbe and beta), 59% with once a week regimen (darbe and beta), 11,55% in two weekly doses (beta) and 4,5% in three weekly administrations (beta). Doses requirements were different according to administration frequency. More than 85% of patients had haemoglobin > 11 g/dl and no significant difference in haemoglobin levels was achieved in the two groups (beta and darbe). Erythropoietin doses were greater in the group treated with darbe (127 versus 113 UI/kg/week), but inflammation markers were significantly higher as well diabetic patients in this group.

Conclusion: These results suggest that, according to the EBPG’s, mostly patients on PD in Portugal are already being well treated presenting heamoglobin levels in the therapeutic range.