Table 2.
Trends by quarter within 2011 in medication use and laboratory values by dialysis facility 25% and 100% opt-in status
| 25% facilities (N = 11) | 100% facilities (N = 38) | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| N (%), Mean ± SD | Q1 2011 (n = 346) | Q2 2011 (n = 325) | Q3 2011 (n = 311) | Q4 2011 (n = 298) | p-trend | Q1 2011 (n = 1266) | Q2 2011 (n = 1236) | Q3 2011 (n = 1166) | Q4 2011 (n = 1125) | p-trend |
| ESA administration a | ||||||||||
| EPO monthly dose (units) | 67624 ± 64409 | 62226 ± 64937 | 59134 ± 64567 | 54814 ± 57216 | <0.0001 | 46294 ± 48614 | 46071 ± 47388 | 37973 ± 41916 | 40892 ± 43618 | <0.0001 |
| IV EPO monthly dose (units) | 68687 ± 64337 | 63694 ± 65008 | 58813 ± 64117 | 55029 ± 56670 | <0.0001 | 45455 ± 47892 | 45503 ± 46503 | 37300 ± 41087 | 42225 ± 45218 | <0.0001 |
| SC EPO monthly dose (units) | 54904 ± 65232 | 46254 ± 63186 | 62404 ± 70244 | 52500 ± 64087 | 0.89 | 53561 ± 54168 | 51289 ± 54835 | 43056 ± 47596 | 33294 ± 32131 | 0.59 |
| SC (vs.IV) ESA routeb | 25 (7.7) | 26 (8.4) | 26 (8.9) | 24 (8.5) | 0.22 | 112 (9.6) | 105 (9.1) | 122 (11.4) | 152 (14.8) | <0.0001 |
| Other medications c | ||||||||||
| Cinacalcet use | 97 (28.0) | 92 (28.3) | 85 (27.3) | 81 (27.2) | 0.43 | 336 (26.5) | 370 (29.9) | 359 (30.8) | 356 (31.6) | <0.0001 |
| Phosphate binder use | 237 (68.5) | 226 (69.5) | 229 (73.6) | 214 (71.8) | 0.85 | 849 (67.1) | 883 (71.4) | 872 (74.8) | 827 (73.5) | <0.0001 |
| Iron use | 251 (72.5) | 221 (68.0) | 216 (69.5) | 223 (74.8) | 0.9 | 903 (71.3) | 917 (74.2) | 817 (70.1) | 752 (66.8) | 0.004 |
| Oral (vs.IV) iron routeb | 1 (0.4) | 1 (0.5) | 2 (0.9) | 3 (1.3) | - | 8 (0.9) | 13 (1.4) | 14 (1.7) | 13 (1.7) | 0.21 |
| Vitamin D use | 294 (85.0) | 275 (84.6) | 254 (81.7) | 246 (82.6) | 0.20 | 975 (77.0) | 967 (78.2) | 927 (79.5) | 914 (81.2) | 0.001 |
| Oral (vs.IV) vitamin D routeb | 11 (3.7) | 6 (2.1) | 3 (0.2) | 4 (2.1) | 0.03 | 151 (15.5) | 202 (20.9) | 219 (23.6) | 226 (24.7) | <0.0001 |
| Laboratory values a | ||||||||||
| Hemoglobin (g/dL) | 11.3 ± 1.2 | 11.3 ± 1.3 | 11.3 ± 1.3 | 11.0 ± 1.1 | 0.0002 | 11.1 ± 1.3 | 11.0 ± 1.2 | 10.9 ± 1.3 | 10.7 ± 1.2 | <0.0001 |
| Hemoglobin <10 g/dL | 41 (11.8) | 37 (11.4) | 41 (13.2) | 40 (13.4) | 0.34 | 229 (18.1) | 226 (18.3) | 251 (21.5) | 268 (23.8) | <0.0001 |
| Hemoglobin ≥12 g/dL | 96 (27.7) | 92 (28.3) | 87 (28.0) | 52 (17.4) | 0.004 | 314 (24.8) | 225 (18.2) | 210 (18.0) | 132 (11.7) | <0.0001 |
| PTH (pg/dL) | 393.4 ± 332.9 | 500.8 ± 404.4 | 412.1 ± 330.7 | 458.7 ± 355.3 | 0.70 | 380.2 ± 305.9 | 399.2 ± 315.4 | 414.3 ± 321.8 | 436.3 ± 343.7 | <0.0001 |
| Calcium (mg/dL) | 8.8 ± 0.8 | 8.8 ± 0.8 | 8.9 ± 0.7 | 8.9 ± 0.7 | 0.06 | 8.9 ± 0.6 | 8.9 ± 0.7 | 8.9 ± 0.7 | 8.8 ± 0.7 | <0.0001 |
| Phosphorus (mg/dL) | 5.2 ± 1.5 | 5.4 ± 1.7 | 5.4 ± 1.6 | 5.2 ± 1.5 | 0.63 | 5.2 ± 1.6 | 5.3 ± 1.6 | 5.3 ± 1.7 | 5.2 ± 1.6 | 0.14 |
| TSAT (%) | 30.8 ± 12.9 | 30.9 ± 12.7 | 33.0 ± 13.8 | 30.1 ± 11.4 | 0.82 | 32.7 ± 12.5 | 32.9 ± 12.6 | 33.5 ± 12.3 | 31.6 ± 11.7 | 0.19 |
| Ferritin (ng/mL) | 677.7 ± 383.2 | 663.6 ± 409.8 | 739.6 ± 405.9 | 693.8 ± 364.0 | 0.001 | 826.8 ± 438.0 | 849.2 ± 456.3 | 933.5 ± 471.8 | 922.6 ± 472.8 | <0.0001 |
aAssessed during last eligible month in each quarter; bLast administered route in each quarter among users; cAny use during the quarter.
EPO, epoetin alfa; IV, intravenous; SC, subcutaneous; ESA, erythropoiesis stimulating agent; TSAT, transferrin saturation; PTH, parathyroid hormone.