Nephrol Dial Transplant (2003) 18: 89-100
© 2003 European Renal Association-European Dialysis and Transplant Association
PRE-dialysis survey on anaemia management
1 Servicio Nefrología, Hospital Gregorio Marañon, Madrid, Spain, 2 Klinische Abteilung für Nephrologie und Dialyse, Universitätsklinik für Innere Medizin III, Wien, Austria, 3 Department of Renal Medicine, King's College Hospital, London, UK, 4 Service de Néphrologie, Hôpital Tenon, Paris, France, 5 Klinika Chorob Nerek AM, Gdansk, Poland and 6 Division of Nephrology, University Hospital CHUV, Lausanne, Switzerland
Background. The PRE-dialysis survey on anaemia management (PRESAM) was designed to assess the care given to pre-dialysis patients in the 12 months before haemodialysis or peritoneal dialysis, with emphasis on anaemia management.
Methods. For this epidemiological study, a retrospective chart review was conducted for patients who started haemodialysis or peritoneal dialysis between 1 August, 1999 and 6 April, 2000. All adult patients who entered one of the 779 participating centres in 21 European countries, Israel or South Africa were included, except for patients who underwent dialysis only during an acute episode. In addition to demographic characteristics, the study examined the prevalence of anaemia, anaemia management including the use of iron supplementation and epoetin, source of referral to the dialysis centre, comorbidities and major clinical events.
Results. A total of 4333 new dialysis patients were included in the survey. At the first visit to the dialysis centre, 68% of the patients had a haemoglobin (Hb) concentration 
11.0 g/dl; Hb concentration was positively correlated with creatinine clearance rate (r=0.43, P<0.01). Patients who received epoetin had a mean Hb concentration of 8.8 g/dl at the start of epoetin treatment, and 96% of these patients had an Hb concentration 11.0 g/dl. Only 26.5% of the patients received epoetin before dialysis. The length of time under the care of a nephrologist was associated with meeting the European Best Practice Guidelines (EBPG) target Hb concentration, as well as receiving epoetin.
Conclusions. Few pre-dialysis patients met the EBPG target for Hb concentration, despite regular nephrology care.
Keywords: anaemia management; best practice guidelines; epidemiology; epoetin; pre-dialysis
Correspondence and offprint requests to: Prof. Jérôme Rossert, Service de Néphrologie, Hôpital Tenon, 4, Rue de la Chine, F-75970 Paris Cedex 20, France. Email: jerome.rossert{at}tnn.ap-hop-paris.fr
Deceased.
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