6
views
0
recommends
+1 Recommend
1 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Adherencia al tratamiento con agentes estimulantes de la eritropoyesis Translated title: Adherence to treatment with erythropoiesis stimulating agents

      research-article

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Resumen Fundamento Determinar la adherencia al tratamiento con agentes estimulantes de la eritropoyesis (AEE) en pacientes con anemia asociada a enfermedad renal crónica (ERC), y valorar su relación con la respuesta frente a estos AEE. Material y métodos Estudio retrospectivo, observacional, de una cohorte de 198 pacientes con ERC que iniciaron tratamiento con epoetina-β o darbepoetina-α, seguidos durante dos años. Se registraron variables basales, de efectividad (% de consecución de objetivos de hemoglobina (Hb), incremento porcentual de Hb) y adherencia (tasa de posesión de medicación). Se consideró no adherente al paciente cuya adherencia fue <90%. Resultados La adherencia global fue 89,6%, ligeramente superior en darbepoetina-α que en epoetina-β; el 8,6% de los pacientes fueron no adherentes. El 87% cumplió el objetivo de Hb. Los valores de respuesta a AEE no variaron en función del grado de adherencia al tratamiento. Conclusiones La adherencia al tratamiento con AEE fue buena, sin diferencias según la respuesta.

          Translated abstract

          Abstract Background To establish adherence to treatment with erythropoiesis stimulating agents (ESA) in patients with anemia associated to chronic kidney disease (CKD), and analyze its relationship to response to ESA. Methods Retrospective study of a cohort of 198 patients with CKD who started treatment with epoetin-β or darbepoetin-α, followed for two years. Basal characteristics, effectiveness (% of hemoglobin (Hb) target attainment, percentage increase of Hb) and adherence (medication possession rate) were registered. A non-adherent patient was one whose mean adherence was <90%. Results Average global adhesion was 89.6%, slightly higher in treatment with darbepoetin-α than with epoetin-β; 8.6% of patients were non-adherents. Hb target was accomplished in 87% cases. Level of response to ESA treatment was independent of the degree of adherence to treatment. Conclusions Adherence to ESA treatment was good, without differences related to degree of response.

          Related collections

          Most cited references13

          • Record: found
          • Abstract: not found
          • Article: not found

          KDIGO clinical practice guideline for anemia in chronic kidney disease

            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Erythropoiesis-stimulating agent hyporesponsiveness.

            Approximately 5-10% of patients with chronic kidney disease demonstrate hyporesponsiveness to erythropoiesis-stimulating agents (ESA), defined as a continued need for greater than 300 IU/kg per week erythropoietin or 1.5 mug/kg per week darbepoetin administered by the subcutaneous route. Such hyporesponsiveness contributes significantly to morbidity, mortality and health-care economic burden in chronic kidney disease and represents an important diagnostic and management challenge. The commonest causes of ESA resistance are non-compliance, absolute or functional iron deficiency and inflammation. It is widely accepted that maintaining adequate iron stores, ideally by administering iron parenterally, is the most important strategy for reducing the requirements for, and enhancing the efficacy of ESA. There have been recent epidemiologic studies linking parenteral iron therapy to an increased risk of infection and atherosclerosis, although other investigations have refuted this. Inflammatory ESA hyporesponsiveness has been reported to be improved by a number of interventions, including the use of biocompatible membranes, ultrapure dialysate, transplant nephrectomy, ascorbic acid therapy, vitamin E supplementation, statins and oxpentifylline administration. Other variably well-established causes of ESA hyporesponsiveness include inadequate dialysis, hyperparathyroidism, nutrient deficiencies (vitamin B12, folate, vitamin C, carnitine), angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, aluminium overload, antibody-mediated pure red cell aplasia, primary bone marrow disorders, myelosuppressive agents, haemoglobinopathies, haemolysis and hypersplenism. This paper reviews the causes of ESA hyporesponsiveness and the clinical evidence for proposed therapeutic interventions. A practical algorithm for approaching the investigation and management of patients with ESA hyporesponsiveness is also provided.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: found
              Is Open Access

              Documento de la Sociedad Española de Nefrología sobre las guías KDIGO para la evaluación y el tratamiento de la enfermedad renal crónica

              Las nuevas guías internacionales del consorcio KDIGO (Kidney Disease: Improving Global Outcomes) sobre la enfermedad renal crónica (ERC) y sobre el manejo de la presión arterial (PA) en pacientes con ERC constituyen la actualización de las correspondientes guías KDOQI (Kidney Disease Outcomes Quality Initiative) de 2002 y 2004. El objetivo de estos documentos es ofrecer una guía actualizada para el diagnóstico, la evaluación, el manejo y el tratamiento del paciente con ERC. La primera guía conserva la definición de ERC de 2002, pero ofrece una clasificación pronóstica mejorada. Además, se revalúan los conceptos sobre el pronóstico de la ERC, y se establecen recomendaciones para el manejo de los pacientes y sobre los criterios de derivación al especialista en nefrología. La segunda guía conserva el objetivo de una PA 300 mg/g), pero recomienda el objetivo menos estricto de PA < 140/90 mmHg para pacientes con albuminuria normal. El desarrollo de las guías siguió un proceso predeterminado de revisión y evaluación de las evidencias disponibles. Las recomendaciones sobre el manejo y el tratamiento están basadas en la revisión sistemática de los estudios relevantes. El sistema GRADE (Grading of Recommendations Assessment, Development and Evaluation) se utilizó para evaluar la calidad de la evidencia y emitir el grado de recomendación. También se discuten las áreas de incertidumbre de los distintos aspectos tratados.
                Bookmark

                Author and article information

                Journal
                asisna
                Anales del Sistema Sanitario de Navarra
                Anales Sis San Navarra
                Gobierno de Navarra. Departamento de Salud (Pamplona, Navarra, Spain )
                1137-6627
                April 2020
                : 43
                : 1
                : 81-85
                Affiliations
                [2] orgnameHospital Universitario Miguel Servet orgdiv1Servicio de Nefrología
                [1] orgnameHospital Universitario Miguel Servet orgdiv1Servicio de Farmacia
                Article
                S1137-66272020000100009 S1137-6627(20)04300100009
                10.23938/assn.0858
                32242547
                844a4b9e-e3a0-4b66-a58e-699cf840cb53

                This work is licensed under a Creative Commons Attribution-NonCommercial 3.0 International License.

                History
                : 25 March 2020
                : 12 January 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 15, Pages: 5
                Product

                SciELO Spain

                Categories
                Artículos Originales Breves

                Therapeutic adherence,Chronic kidney failure,Anemia,Eritropoyetina,Epoetina alfa,Enfermedad renal crónica,Adherencia terapéutica,Erythropoietin,Epoetin alfa

                Comments

                Comment on this article