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. 2004 Jan;19(1):121-32.
doi: 10.1093/ndt/gfg458.

Anaemia in haemodialysis patients of five European countries: association with morbidity and mortality in the Dialysis Outcomes and Practice Patterns Study (DOPPS)

Francesco Locatelli  1 , Ronald L Pisoni, Christian Combe, Juergen Bommer, Vittorio E Andreucci, Luis Piera, Roger Greenwood, Harold I Feldman, Friedrich K Port, Philip J Held
Affiliations

Anaemia in haemodialysis patients of five European countries: association with morbidity and mortality in the Dialysis Outcomes and Practice Patterns Study (DOPPS)

Francesco Locatelli et al. Nephrol Dial Transplant. 2004 Jan.

Erratum in

  • Nephrol Dial Transplant. 2004 Jun;19(6):1666

Abstract

Background: The Dialysis Outcomes and Practice Patterns Study (DOPPS) is a prospective, observational study based on data collected from nationally representative samples of haemodialysis facilities. The burden of anaemia in haemodialysis patients is substantial, leading to considerable morbidity, mortality and reduced quality of life. This study examines anaemia management and outcomes based on data from five European countries participating in the DOPPS: France, Germany, Italy, Spain and the UK.

Methods: Baseline data on demographics, co-morbidities and anaemia management in 4591 haemodialysis patients from 101 nephrology facilities were collected in 1998-2000. Using multivariate Cox survival analyses to adjust for patient characteristics, relationships between haemoglobin concentration at study entry and rates of mortality and hospitalization were evaluated.

Results: For a year 2000 sample of prevalent patients on haemodialysis >180 days, mean haemoglobin concentration was 11.0 g/dl; 53% had a haemoglobin concentration > or = 11 g/dl [1998-1999 = 44% (P < 0.05)]. In 2000, 84% of prevalent patients were prescribed recombinant human erythropoietin (rHuEpo). Higher haemoglobin concentrations were associated with decreased relative risk (RR) for mortality (RR = 0.95 for every 1 g/dl higher haemoglobin, P = 0.03) and hospitalization (RR = 0.96, P = 0.02). Patients with haemoglobin <10 g/dl were 29% more likely to be hospitalized than patients with haemoglobin 11-12 g/dl (P < 0.001).

Conclusion: Even after adjustment, lower haemoglobin concentrations were associated with higher morbidity and mortality in European haemodialysis patients. A trend to increased haemoglobin concentrations was observed following publication of the European Best Practice Guidelines (EBPG) on anaemia management for chronic kidney disease patients, but efforts must continue to achieve EBPG goals.

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Comment in

  • Does dose matter?
    Zhang Y, Thamer M, Stefanik K, Cotter DJ. Zhang Y, et al. Nephrol Dial Transplant. 2004 Jun;19(6):1658; author reply 1658-9. doi: 10.1093/ndt/gfh233. Nephrol Dial Transplant. 2004. PMID: 15150368 No abstract available.
  • Conflict of interest.
    Shaldon S. Shaldon S. Nephrol Dial Transplant. 2004 Nov;19(11):2928. doi: 10.1093/ndt/gfh396. Nephrol Dial Transplant. 2004. PMID: 15496576 No abstract available.

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