Red Blood Cell Transfusion Rate Highest With Persistent ESA Hyporesponse

Use of red blood cell transfusion (RBCT) to treat anemia in patients receiving dialysis increases with persistent hyporesponse to erythropoiesis-stimulating agents (ESA), according to study data presented at the National Kidney Foundation’s 2023 Spring Clinical Meetings in Austin, Texas.

The mean number of days with RBCTs was higher for patients with persistent ESA hyporesponsiveness (60% of months or more) than for those with acute hyporesponsiveness (less than 60% of months): 3.3, 2.1, and 2.8 days for those receiving hemodialysis, peritoneal dialysis, and a combination of these modalities, respectively, compared with 1.1, 0.7, and 1.5 days, respectively.

Among patients not experiencing hyporesponse to ESAs, the mean number of days with RBCTs was 0.3, 0.3, and 0.6 days, study investigators Christine Ferro, a consultant with Milliman, Inc., in New York, New York, and colleagues reported in a poster presentation.

“These findings suggest that patients with hyporesponse incur costly healthcare utilization, and anemia treatment alternatives are needed,” the investigators concluded.

The study included 206,670 patients receiving dialysis, of whom 21,302 (10.3%) met the definition for hyporesponse to ESAs: 2 or more consecutive months in which the mean ESA weekly dose was higher than 300 epoetin alfa units/kg of body weight and a hemoglobin level in the prior month was lower than 10 g/dL. Of the 21,302 patients, 3554 (16.7%) had persistent hyporesponsiveness.

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