Background: Transfusion patterns are not well characterized in non-dialysis (ND) chronic kidney disease (CKD)\r\npatients. This study describes the proportion of patients transfused, units of blood transfused and triggerhemoglobin\r\n(Hb) levels for transfusions in severe anemic, ND-CKD patients in routine practice.\r\nMethods: A retrospective cohort study of electronic medical record data from the Henry Ford Health System\r\nidentified 374 adult, ND-CKD patients with severe anemia (Hb < 10 g/dL and subsequent use of erythropoiesisstimulating\r\nagents [ESA] therapy, blood transfusions, or a second Hb < 10 g/dL) between January 2004 and June\r\n2008. Exclusions included those with prior diagnoses of cancer, renal or liver transplant, end-stage renal disease,\r\nacute bleeding, trauma, sickle cell disease, or aplastic anemia. A gap of = 1 days between units of blood transfused\r\nwas counted as a separate transfusion.\r\nResults: At least 1 transfusion (mean of 2 units; range, 1-4) was administered to 20% (75/374) of ND-CKD patients\r\nwith mean (�± SD) follow-up of 459 (�± 427) days. The mean (�± SD) Hb level closest and prior to a transfusion was\r\n8.8 (�± 1.5) g/dL. Patients who were hospitalized in the 6 months prior to their first anemia diagnosis were 6.3 times\r\nmore likely to receive a blood transfusion than patients who were not hospitalized (p < 0.0001). Patients with\r\nperipheral vascular disease (PVD) were twice as likely to have a transfusion as patients without PVD (p = 0.04).\r\nConclusions: Transfusions were prevalent and the trigger hemoglobin concentration was approximately 9 g/dL\r\namong ND-CKD patients with anemia. To reduce the transfusion burden, clinicians should consider other anemia\r\ntreatments including ESA therapy.
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