Evidence map›Paper›PMID 26439712›Full record

ArticleAmerican journal of nephrology2015

Trends in Anemia Management in Hemodialysis Patients with Cancer.

Anne M Butler, Abhijit V Kshirsagar, Andrew F Olshan, Matthew E Nielsen, Stephanie B Wheeler, M Alan Brookhart

Open access · bronzeAbstract read
In one paragraph

Article in American journal of nephrology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.8field-weighted citation impact, top 25% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 7 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 2 countries.

Anne M ButlerDepartment of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, N.C., USA.
Abhijit V Kshirsagar
Andrew F Olshan
Matthew E Nielsen
Stephanie B Wheeler
M Alan Brookhart
Cecil College · USSegeberger Kliniken · DEUniversity of North Carolina at Chapel Hill · US

Funding

RENAL EPIDEMIOLOGY TRAINING PROGRAMT32DK007750 · NIDDK · UNIV OF NORTH CAROLINA CHAPEL HILL · PI FALK, RONALD J · 1999 to 2022
$5.5M
Propensity Scores and Preventive Drug Use in the ElderlyR01AG023178 · NIA · UNIV OF NORTH CAROLINA CHAPEL HILL · PI STURMER, TIL · 2005 to 2014
$2.7M
TRAINING GRANT IN CANCER EPIDEMIOLOGYT32CA009330 · NCI · UNIV OF NORTH CAROLINA CHAPEL HILL · PI OLSHAN, ANDREW · 1985 to 2010
$2.5M
A retrospective cohort study of the safety of testosterone therapy in older menR01AG042845 · NIA · UNIV OF NORTH CAROLINA CHAPEL HILL · PI BROOKHART, MAURICE ALAN · 2012 to 2013
$476k
Patterns of use, comparative effectiveness, and safety of rotavirus vaccinesR21HD080214 · NICHD · UNIV OF NORTH CAROLINA CHAPEL HILL · PI BROOKHART, MAURICE ALAN · 2014 to 2015
$413k
NCI NIH HHS 5 T32 CA009330-30NCI NIH HHS T32 CA009330NIA NIH HHS R01 AG023178NIA NIH HHS R01 AG042845NICHD NIH HHS R21 HD080214NIDDK NIH HHS 2 T32 DK007750-15NIDDK NIH HHS T32 DK007750
6 · The paper itself

Abstract

backgroundErythropoiesis-stimulating agents (ESAs), intravenous iron, and blood transfusion are used to treat anemia in both end-stage renal disease (ESRD) and cancer. However, anemia treatment patterns have not been described among ESRD patients undergoing hemodialysis with concurrent cancer, especially in the recent era of ESA-related safety concerns.

methodsWe analyzed Medicare data from a cohort of hemodialysis patients diagnosed with incident cancer. We used multivariable generalized linear models to estimate trends and patterns in ESA use, iron use, transfusion use, epoetin alfa (EPO) dose, iron dose, and resulting hemoglobin levels (2000-2011).

resultsOf 43,760 eligible patients, quarterly ESA use declined slightly from a peak of 94.1 to 90.0%. Quarterly EPO dose increased from 2000 to 2004, then declined; quarterly hemoglobin levels followed a similar pattern. Iron use increased rapidly from 46.9 to 79.3%. Iron dose increased until 2010 and then declined. There was an increase in the quarterly transfusion use (6.3-11.7%) and in the mean number of transfusion days per year (1.4-1.8). Anemia treatment patterns varied by demographic/clinical subgroups, especially among patients receiving chemotherapy, who required higher ESA use, EPO dose, and frequency of transfusions.

conclusionsDespite safety concerns about ESAs in both the ESRD and cancer populations, the proportion of hemodialysis patients with cancer who used ESAs between 2000 and 2011 remained extremely high. EPO dose and hemoglobin levels increased and then decreased. Iron use, iron dose, and transfusions increased substantially. Future research examining the risk-benefit profile of different anemia management strategies in the dialysis population with cancer is needed.

Indexed as

AgedAged, 80 and overAnemiaCohort StudiesFemaleHumansKidney Failure, ChronicMaleMiddle AgedNeoplasmsNephrologyRenal Dialysis

Identifiers

PMID26439712
PMCPMC4618160
OpenAlexW1928994033

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.