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AN EVIDENCE‐BASED APPROACH TO ANAEMIA MANAGEMENT IN PREDIALYSIS CHRONIC KIDNEY DISEASE
Author(s) -
PughClarke Karen,
Cooper Liz,
Turner June,
Fermin Jenny
Publication year - 2009
Publication title -
journal of renal care
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.381
H-Index - 27
eISSN - 1755-6686
pISSN - 1755-6678
DOI - 10.1111/j.1755-6686.2009.00128.x
Subject(s) - medicine , kidney disease , intensive care medicine , population , protocol (science) , iron deficiency , clinical trial , anemia , alternative medicine , pathology , environmental health
SUMMARY The use of Evidence‐based practice (EBP) is a decision‐making process, which integrates the best available research, clinician expertise, and client characteristics, integrating quality patient care in terms of clinical outcomes and cost‐effectiveness. This paper describes the application of EBP to an outpatient intravenous (IV) iron clinic for patients with predialysis chronic kidney disease (CKD). There has been an increasing focus on managing anaemia in patients with predialysis CKD. Along with the use of erythropoiesis stimulating agents, there has been an emerging interest in the use of IV iron preparations to treat anaemia in this patient population. Using EBP, we introduced a single dose preparation Ferinject ® to replace our original IV iron protocol using Venofer ® . As a test dose of Ferinject ® is not required, it is extremely appropriate for use in busy nurse‐led IV iron clinics. Based upon the evidence generated from our initial trial of using Ferinject ® , and our clinical experience of using this preparation, we have now converted our IV iron protocol to Ferinject ® . Although the evaluation of Ferinject ® in our predialysis population is ongoing, we are continuing to observe the benefits of using this preparation, both in terms of patient outcome and cost‐effectiveness. We consider that the use of Ferinject ® has reduced waiting time and waiting list pressure, and also reduced material and hospital transport costs, which are significant due to the large geographical area covered by our CKD service.