Trends in @entity417 Management in Hemodialysis XXXX with @entity5 .

@entity1 @entity417 @entity5 @entity1307 @entity68 @entity454
BACKGROUND: Erythropoiesis-stimulating agents (ESAs), intravenous @entity68 , and blood transfusion are used to treat @entity417 in both @entity454 ( @entity454 ) and @entity5 . However, @entity417 treatment patterns have not been described among @entity454 @entity1 undergoing hemodialysis with concurrent @entity5 , especially in the recent era of ESA-related safety concerns. METHODS: We analyzed Medicare data from a cohort of hemodialysis @entity1 diagnosed with incident @entity5 . We used multivariable generalized linear models to estimate trends and patterns in ESA use, @entity68 use, transfusion use, @entity1307 alfa ( @entity1307 ) dose, @entity68 dose, and resulting hemoglobin levels (2000-2011). RESULTS: Of 43,760 eligible @entity1 , quarterly ESA use declined slightly from a peak of 94.1 to 90.0%. Quarterly @entity1307 dose increased from 2000 to 2004, then declined; quarterly hemoglobin levels followed a similar pattern. @entity68 use increased rapidly from 46.9 to 79.3%. @entity68 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). @entity417 treatment patterns varied by demographic/clinical subgroups, especially among @entity1 receiving chemotherapy, who required higher ESA use, @entity1307 dose, and frequency of transfusions. CONCLUSIONS: Despite safety concerns about ESAs in both the @entity454 and @entity5 populations, the proportion of hemodialysis @entity1 with @entity5 who used ESAs between 2000 and 2011 remained extremely high. @entity1307 dose and hemoglobin levels increased and then decreased. @entity68 use, @entity68 dose, and transfusions increased substantially. Future research examining the risk-benefit profile of different @entity417 management strategies in the dialysis population with @entity5 is needed.
