Hemoglobin, EPO, & Iron dose figure 4

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Presentation transcript:

Hemoglobin, EPO, & Iron dose figure 4 Hemoglobin, EPO, & Iron dose figure 4.1 period prevalent hemodialysis patients

Mean monthly hemoglobin at initiation of therapy & in the first 6 months of ESRD figure 4.2, incident hemodialysis patients

Mean EPO dose per week after initiation of & in the first 6 months of ESRD figure 4.3, incident hemodialysis patients

Percent of patients receiving iron at initiation of therapy & in the first 6 months of ESRD figure 4.4, incident hemodialysis patients

Mean monthly hemoglobin by initial Hb from the ME form figure 4 Mean monthly hemoglobin by initial Hb from the ME form figure 4.5, incident dialysis patients, 1995-2000 combined

Mean EPO dose per week by initial Hb from the ME form figure 4 Mean EPO dose per week by initial Hb from the ME form figure 4.6, incident dialysis patients, 1995-2000 combined

Percentage of patients receiving iv iron by initial Hb from the ME form figure 4.7, incident dialysis patients, 1995-2000 combined

Prevalent patient counts, by data source table 4 Prevalent patient counts, by data source table 4.a, point prevalent ESRD patients; only patients with data in both databases

Prevalent patient counts, by data source table 4 Prevalent patient counts, by data source table 4.a, point prevalent ESRD patients; only patients with data in both databases (cont.)

Trends in mean hemoglobin, by modality, iron use, data source, & EPO use figure 4.8

Trends in mean hemoglobin, by modality, iron use, data source, & EPO use figure 4.8 (cont.)

Trends in mean EPO dose per week, by modality, iron use, & data source figure 4.9

Trends in mean EPO dose per week, by modality, iron use, & data source figure 4.9 (cont.)

Trends in mean hemoglobin, by modality, age, gender, & race/ethnicity figure 4.10, period prevalent dialysis patients

Trends in mean EPO dose per week, by modality, age, gender, & race/ethnicity figure 4.11, period prevalent dialysis patients

Trends in mean hemoglobin, by modality, age, gender, & race/ethnicity figure 4.10, period prevalent dialysis patients

Trends in mean hemoglobin, by modality, age, gender, & race/ethnicity figure 4.10, period prevalent dialysis patients (cont.)

Trends in mean EPO dose per week, by modality, age, gender, & race/ethnicity figure 4.11, period prevalent dialysis patients

Trends in mean EPO dose per week, by modality, age, gender, & race/ethnicity figure 4.11, period prevalent dialysis patients (cont.)

Trends in patient distribution, by mean monthly hemoglobin figure 4 Trends in patient distribution, by mean monthly hemoglobin figure 4.12, period prevalent dialysis patients 100 13+ 12.5-<13 80 12-<12.5 s t 60 en ti a 11-<12 p f o t 40 en rc e P 10-<11 20 <10 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

Trends in patient distribution, by rolling three-month mean hemoglobin figure 4.13, period prevalent dialysis patients 100 13+ 12.5-<13 80 12-<12.5 s t 60 11-<12 en ti a p f o t en 40 rc e P 20 10-<11 <10 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

Trends in mean monthly hemoglobin & mean EPO dose per week figure 4 Trends in mean monthly hemoglobin & mean EPO dose per week figure 4.14, period prevalent dialysis patients

Mean hemoglobin: hemodialysis figure 4 Mean hemoglobin: hemodialysis figure 4.15, period prevalent hemodialysis patients, 2000, by HSA, unadjusted Mean hemoglobin (g/dl) 11.69+ (11.87) 11.57 to <11.69 11.45 to <11.57 11.30 to <11.45 below 11.30 (11.11)

Mean EPO dose: hemodialysis figure 4 Mean EPO dose: hemodialysis figure 4.16, period prevalent hemodialysis patients, 2000, by HSA, unadjusted Mean weekly EPO dose 17,030+ (19,707) 15,270 to <17,030 13,880 to <15,270 12,120 to <13,880 below 12,120 (9,976)

Mean hemoglobin, all-cause infections: no infections figure 4 Mean hemoglobin, all-cause infections: no infections figure 4.17, period prevalent hemodialysis patients, 2000, by HSA, unadjusted Mean hemoglobin (g/dl) 11.79+ (12.00) 11.64 to <11.79 11.52 to <11.64 11.36 to <11.52 below 11.36 (11.10)

Mean hemoglobin, all-cause infections: 1-2 infections figure 4 Mean hemoglobin, all-cause infections: 1-2 infections figure 4.17, period prevalent hemodialysis patients, 2000, by HSA, unadjusted Mean hemoglobin (g/dl) 11.79+ (12.04) 11.64 to <11.79 11.52 to <11.64 11.36 to <11.52 below 11.36 (11.04)

Mean hemoglobin, all-cause infections: 2-3 infections figure 4 Mean hemoglobin, all-cause infections: 2-3 infections figure 4.17, period prevalent hemodialysis patients, 2000, by HSA, unadjusted Mean hemoglobin (g/dl) 11.79+ (12.08) 11.64 to <11.79 11.52 to <11.64 11.36 to <11.52 below 11.36 (10.97)

Mean hemoglobin, all-cause infections: 3-5 infections figure 4 Mean hemoglobin, all-cause infections: 3-5 infections figure 4.17, period prevalent hemodialysis patients, 2000, by HSA, unadjusted Mean hemoglobin (g/dl) 11.79+ (12.20) 11.64 to <11.79 11.52 to <11.64 11.36 to <11.52 below 11.36 (10.79)

Mean hemoglobin, all-cause infections: 5+ infections figure 4 Mean hemoglobin, all-cause infections: 5+ infections figure 4.17, period prevalent hemodialysis patients, 2000, by HSA, unadjusted Mean hemoglobin (g/dl) 11.79+ (12.34) 11.64 to <11.79 11.52 to <11.64 11.36 to <11.52 below 11.36 (10.53)

Mean hemoglobin, all-cause infections: at least 1 infection figure 4 Mean hemoglobin, all-cause infections: at least 1 infection figure 4.17, period prevalent hemodialysis patients, 2000, by HSA, unadjusted Mean hemoglobin (g/dl) 11.79+ (12.10) 11.64 to <11.79 11.52 to <11.64 11.36 to <11.52 below 11.36 (11.02)

Mean weekly EPO dose, all-cause infections: no infections figure 4 Mean weekly EPO dose, all-cause infections: no infections figure 4.18, period prevalent hemodialysis patients, 2000, by HSA, unadjusted Mean EPO dose 16,330+ (19,026) 14,590 to <16,330 13,250 to <14,590 11,550 to <13,250 below 11,550 (9,402)

Mean weekly EPO dose, all-cause infections: 1-2 infections figure 4 Mean weekly EPO dose, all-cause infections: 1-2 infections figure 4.18, period prevalent hemodialysis patients, 2000, by HSA, unadjusted Mean EPO dose 16,330+ (20,759) 14,590 to <16,330 13,250 to <14,590 11,550 to <13,250 below 11,550 (8,305)

Mean weekly EPO dose, all-cause infections: 2-3 infections figure 4 Mean weekly EPO dose, all-cause infections: 2-3 infections figure 4.18, period prevalent hemodialysis patients, 2000, by HSA, unadjusted Mean EPO dose 16,330+ (21,947) 14,590 to <16,330 13,250 to <14,590 11,550 to <13,250 below 11,550 (8,044)

Mean weekly EPO dose, all-cause infections: 3-5 infections figure 4 Mean weekly EPO dose, all-cause infections: 3-5 infections figure 4.18, period prevalent hemodialysis patients, 2000, by HSA, unadjusted Mean EPO dose 16,330+ (22,375) 14,590 to <16,330 13,250 to <14,590 11,550 to <13,250 below 11,550 (8,144)

Mean weekly EPO dose, all-cause infections: 5+ infections figure 4 Mean weekly EPO dose, all-cause infections: 5+ infections figure 4.18, period prevalent hemodialysis patients, 2000, by HSA, unadjusted Mean EPO dose 16,330+ (22,235) 14,590 to <16,330 13,250 to <14,590 11,550 to <13,250 below 11,550 (7,891)

Mean weekly EPO dose, all-cause infections: at least 1 infection figure 4.18, period prevalent hemodialysis patients, 2000, by HSA, unadjusted Mean EPO dose 16,330+ (20,287) 14,590 to <16,330 13,250 to <14,590 11,550 to <13,250 below 11,550 (8,542)

Mean hemoglobin & mean EPO dose per week: all-cause infections figure 4.19, period prevalent hemodialysis patients age 20+, 2000

Mean hemoglobin & mean EPO dose per week: all-cause infections figure 4.19, period prevalent hemodialysis patients age 20+, 2000 (cont.) Number of inpatient hospital stays, per patient year at risk, with infection as the principal diagnosis All · All patients, regardless of status 1+ · Patients with at least one stay during year A · Patients with no stays B · Patients with 1–<2 stays C · Patients with 2–<3 stays D · Patients with 3–<5 stays E · Patients with five or more stays

Mean hemoglobin & mean EPO dose per week: catheter infections figure 4 Mean hemoglobin & mean EPO dose per week: catheter infections figure 4.20, period prevalent hemodialysis patients age 20+, 2000

Mean hemoglobin & mean EPO dose per week: catheter infections figure 4 Mean hemoglobin & mean EPO dose per week: catheter infections figure 4.20, period prevalent hemodialysis patients age 20+, 2000 (cont.) Number of inpatient hospital stays, per patient year at risk, with infection as the principal diagnosis All · All patients, regardless of status 1+ · Patients with at least one stay during year A · Patients with no stays B · Patients with 1–<2 stays C · Patients with 2–<3 stays D · Patients with 3–<5 stays E · Patients with five or more stays

Mean hemoglobin & mean EPO dose per week: catheter insertions figure 4 Mean hemoglobin & mean EPO dose per week: catheter insertions figure 4.21, period prevalent hemodialysis patients age 20+, 2000

Mean hemoglobin & mean EPO dose per week: catheter insertions figure 4 Mean hemoglobin & mean EPO dose per week: catheter insertions figure 4.21, period prevalent hemodialysis patients age 20+, 2000 (cont.) Number of catheter (temporary & permanent) insertions per patient year All · All patients, regardless of status 1+ · Patients with at least one insertion during year a · Patients with no insertions b · Patients with 1 insertion c · Patients with >1–2 insertions d · Patients with >2–3 insertions e · Patients with three or more insertions

Distribution of median URR, by data source figure 4.22

Distribution of median URR, by gender (claims data) figure 4 Distribution of median URR, by gender (claims data) figure 4.23, period prevalent hemodialysis patients

Geographic variations in the % of patients meeting the K/DOQI target URR of 65%: 1998 figure 4.24, period prevalent hemodialysis patients, by HSA, unadjusted Percent of patients 87.1+ (89.2) 86.1 to <87.1 85.3 to <86.1 84.0 to <85.3 below 84.0 (81.1)

Geographic variations in the % of patients meeting the K/DOQI target URR of 65%: 1999 figure 4.24, period prevalent hemodialysis patients, by HSA, unadjusted Percent of patients 87.1+ (89.0) 86.1 to <87.1 85.3 to <86.1 84.0 to <85.3 below 84.0 (82.7)

Geographic variations in the % of patients meeting the K/DOQI target URR of 65%: 2000 figure 4.24, period prevalent hemodialysis patients, by HSA, unadjusted Percent of patients 87.1+ (88.8) 86.1 to <87.1 85.3 to <86.1 84.0 to <85.3 below 84.0 (83.3)

Geographic variations in the % of pts meeting the K/DOQI target URR of 65%: % change, 1998-2000 figure 4.24, period prevalent hemodialysis patients, by HSA, unadjusted Percent change, 1998-2000 7.45+ (9.98) 5.76 to <7.45 4.22 to <5.76 2.52 to <4.22 below 2.52 (1.24)

Median URR, by unit characteristics: hemodialysis patients figure 4 Median URR, by unit characteristics: hemodialysis patients figure 4.25, period prevalent hemodialysis patients, claims data, 2000

Trends in mean weekly Kt/V, by unit characteristics: peritoneal dialysis patients figure 4.26, CPM data

Trends in mean weekly creatinine clearance, by unit characteristics: peritoneal dialysis patients figure 4.27, CPM data

Trends in access use, by data source figure 4 Trends in access use, by data source figure 4.28, hemodialysis patients

Access insertions, by unit characteristics figure 4 Access insertions, by unit characteristics figure 4.29, hemodialysis patients, 2000, CDC data

Insertion rates for temporary & permanent central catheters, & creation rates for simple fistulas figure 4.30, period prevalent hemodialysis patients

Trends in vascular access event rates, by event type figure 4 Trends in vascular access event rates, by event type figure 4.31, period prevalent hemodialysis patients

Trends in vascular access event rates, by event type figure 4 Trends in vascular access event rates, by event type figure 4.31, period prevalent hemodialysis patients (cont.)

Vascular access event rates, by MD specialty figure 4 Vascular access event rates, by MD specialty figure 4.32, period prevalent hemodialysis patients

Geographic variations in temporary catheter insertion rates figure 4 Geographic variations in temporary catheter insertion rates figure 4.33, period prevalent hemodialysis patients, 2000, by HSA, unadjusted Rate per 1,000 patient years at risk 403+ (535) 298 to <403 225 to <298 165 to <225 below 165 (132)

Geographic variations in permanent catheter insertion rates figure 4 Geographic variations in permanent catheter insertion rates figure 4.33, period prevalent hemodialysis patients, 2000, by HSA, unadjusted Rate per 1,000 patient years at risk 302+ (386) 237 to <302 193 to <237 150 to <193 below 150 (121)

Geographic variations in simple fistula creation rates figure 4 Geographic variations in simple fistula creation rates figure 4.33, period prevalent hemodialysis patients, 2000, by HSA, unadjusted Rate per 1,000 patient years at risk 94.0+ (119.3) 78.5 to <94.0 66.0 to <78.5 53.9 to <66.0 below 53.9 (44.2)

Patient distribution, by hemoglobin & weekly EPO dose: IgA nephropathy/Berger’s, IgM nephropathy figure 4.34, period prevalent dialysis patients, 1999-2000 combined

Patient distribution, by iron vials & weekly EPO dose: IgA nephropathy/Berger’s, IgM nephropathy figure 4.35, period prevalent dialysis patients, 1999-2000 combined

Patient distribution, by hemoglobin & weekly EPO dose: Goodpasture’s syndrome figure 4.36, period prevalent dialysis patients, 1999-2000 combined

Patient distribution, by iron vials & weekly EPO dose: Goodpasture’s syndrome figure 4.37, period prevalent dialysis patients, 1999-2000 combined

Patient distribution, by hemoglobin & weekly EPO dose: lupus erythematosus figure 4.38, period prevalent dialysis patients, 1999-2000 combined

Patient distribution, by iron vials & weekly EPO dose: lupus erythematosus figure 4.39, period prevalent dialysis patients, 1999-2000 combined

Patient distribution, by hemoglobin & weekly EPO dose: other secondary GN/vasculitis figure 4.40, period prevalent dialysis patients, 1999-2000 combined

Patient distribution, by iron vials & weekly EPO dose: other secondary GN/vasculitis figure 4.41, period prevalent dialysis patients, 1999-2000 combined

Patient distribution, by hemoglobin & weekly EPO dose: scleroderma figure 4.42, period prevalent dialysis patients, 1999-2000 combined

Patient distribution, by iron vials & weekly EPO dose: scleroderma figure 4.43, period prevalent dialysis patients, 1999-2000 combined

Patient distribution, by hemoglobin & weekly EPO dose: Alport’s, other hereditary figure 4.44, period prevalent dialysis patients, 1999-2000 combined

Patient distribution, by iron vials & weekly EPO dose: Alport’s, other hereditary figure 4.45, period prevalent dialysis patients, 1999-2000 combined

Patient distribution, by hemoglobin & weekly EPO dose: multiple myeloma, light chain nephropathy figure 4.46, period prevalent dialysis patients, 1999-2000 combined

Patient distribution, by iron vials & weekly EPO dose: multiple myeloma, light chain nephropathy figure 4.47, period prevalent dialysis patients, 1999-2000 combined

Patient distribution, by hemoglobin & weekly EPO dose: AIDS figure 4 Patient distribution, by hemoglobin & weekly EPO dose: AIDS figure 4.48, period prevalent dialysis patients, 1999-2000 combined

Patient distribution, by iron vials & weekly EPO dose: AIDS figure 4 Patient distribution, by iron vials & weekly EPO dose: AIDS figure 4.49, period prevalent dialysis patients, 1999-2000 combined )