Acute Interstitial Nephritis

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(Epoetin alfa);. 1988; 27%. Aranesp®. (Darbepoetin alfa); 213; 3%. Recormon®. (Epoetin beta);. 118; 1%. Mircera®. (Pegylated. Epoetin); 13;. 0%. Epoetin Alfa;.

Result from Unified data collection form among HD patients (Ain Shams Experience) Dr. Yahya Makkeyah October 2013

Participants

22 Candidates

7 Governorates 100 Centers

Centers Data

Centers 2 44

Military

54

Go vernomental Private

7403 Patient

Number of machines per center (4-70) Number of patients per center

(5-276)

Patients Data

Demographics Age (51.78±0.15) [4-92]

Gender Gender 40% 60%

Male

Female

Etiology of ESRD 35.0

31.2

30.0 25.0 20.0

20.4

20.2

15.0 9.1

10.0 5.0 0.0

4.3

3.9

3.6

1.4

4.4

1.4

Sponsoring (Dialysis Financial Support) 70.0

64.7

60.0 50.0 40.0 30.0

27.5

20.0 10.0 0.0

1.6

2.6

3.6

Co-morbidities

1147

1553 IHD

7019

7063

218

332

6223

7102

6703

292

692 Arthropathy

5842

COPD

6186

DM

3246

Yes

No

1170 CLD

CVS

PVD

4153

HTN

100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0%

Virology state 155, 2.4%

100%

5

90% 80% 70% 60%

3339, 46.4%

50%

Positive

40%

Negative

30% 20% 10% 0%

3859

6327

6459

HCV

HBV

HIV

Vascular Access Type

Failure AV fistula; 6861; 93%

AV graft; 144; 2%

None; 5100; 74%

Cather; 391; 5%

Yes; 1824; 26%

Vascular access failure 1400 1169, 15.8%, 1200 64.3% 1000 800 600

399, 5.4%, 21.9%

400

160

200

57

19

9

1

4

1

4.00

5.00

6.00

7.00

8.00

10.00

0

1.00

2.00

3.00

Quality of life 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0%

3549 2964

5955

3847, 52% 883, 11.9%, 23%

1441, 19.5% Employment

Dependency Yes

No

Wheel Chair Bound

Dialysis Period (years) 4.63±0.44 [0.08-28]

Frequency of dialysis

Duration of dialysis

120.00

100.00 90.00

100.00

80.00 70.00

80.00

60.00 50.00

60.00 40.00 30.00

40.00

20.00

0.08

3 times/wk

4 times/wk

89.57

0.04 4.5 hours/session

95.51

5.90

4 hours/session

4.34

4.49

3.5 hours/session

0.07

2 times/wk

0.00

Once weekly

0.00

3 hours/session

10.00

20.00

Anticoagulation Use

HMWH; 4622; 62%

LMWH; 2715; 37%

None; 56; 1%

LMWH Use

Fraxiparine® 86%

Clexane® 4% Innohep® 10%

Heparin Dose 1800

1617

1600

1340

1400 1200 1000 800 576

600 319

400 200 0

107

138 8

6

Dialysate Type

Acetate buffer 19% Bicarbonate buffer 81%

Dialysate Sodium (mmol/l)

138.00 12% 137.00 53%

140.00 5%

134.00 11%

135.00 19%

Dialysate Calcium (mmol/l) 1.75 47%

1.50 32%

1.25 21%

Dialysate Magnesium (mmol/l)

0.75 17%

0.5 83%

Dialysate Potasium (mmol/l)

2.00 88% 1.50 12%

Dialyzer type

High Flux 8%

Low flux 92%

Dialyzer sterilization

Gamma irradiation 2%

Ethylene Oxide 58%

Steam 40%

Dialyzer surface area 1.40 m2 8%

1.60 m2 19%

1.70 m2 5% 1.80 m2 2%

1.30 m2 63%

2.10 m2 1.00 0%

1.10 m2 m2 0% 3% 1.20 m2 0%

Hemoglobin (gm/dl) Categories 35.00

32.30%

30.00 25.00 20.00

18.60%

17.91%

17.01% 14.17%

15.00 10.00 5.00 0.00 ≤8

8-9

9.01-10.5

10.51-11.5

>11.5

Iron indices Serum iron 76.53±1.64

Serum ferritin 759.63±30.67

Iron indices TIBC 294.45±3.37

TSAT 30.9±0.62

Iron indices s.Ferritin

TSAT

44%

47% 53%

≤500

>500

56%

≤30

>30

Blood Transfusion use

3033; 44% 3823; 56%

No

Yes

ESA therapy ESA Use 1067; 14% 3970; 54%

None

2332; 32%

Originator

Generic

ESA therapy ESA Band

Mircera® (Pegylated Epoetin); 13; 0% Recormon® (Epoetin beta); 118; 1% Aranesp® (Darbepoetin alfa); 213; 3%

Epoetin Alfa; 3970; 54%

Eprex® (Epoetin alfa); 1988; 27%

Un-Identified; 1101; 15%

17 7 1 1 1

24000.00 40000.00

4

20000.00

448

16000.00

1000

12000.00

9000.00

1500

8000.00

6

6000.00

43

5000.00

4000

4000.00

3000.00

500

2000.00

23

1000.00

0

2

500.00

Epoetin Alfa Dose 3688

3500

3000

2500

2000

1138 560

Iron Therapy

3131; 42% 4244; 58%

None

Yes

Vitamin B Complex Supplement 1225; 17%

6172; 83%

None

Yes

Folic acid supplement

1488; 29%

3565; 71%

None

Yes

L-Carnitine supplement

3248; 48% 3526; 52%

None

Yes

Serum Calcium 8.41-10.2 mg/dl 48%

≤8.4 mg/dl 47%

>10.2 mg/dl 5%

Serum Phosphorus

3.51-5.5 mg/dl 48%

>5.5 mg/dl 43%

≤3.5 mg/dl 9%

Ca X PO4 Product

55 23%

PTH 301600 25% 151300 20%

601900 16% >900 19%

≤150 20%

560.84±14.09

Phosphorus Binders Use 8000 6802, 93.1%

7000 6000 5000 4000 3000 2000 1000

423, 5.8%

0 None

Calcium only

31, 0.4%

51, 0.7%

Sevelamer only

Calcium & Sevelamer

Vitamin D Use Yes 74%

None 26%

1.64±0.025 ug/Week

Cinacalcet Use None 98%

Yes 2%

Dialysis Complications 181 2666

2128

2383

1704

None

Yes

Fractures

5458

Itching

4843

Bony aches

4410

5044

Cramps

6866

Hypotension

100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0%

Dry Weight 73.21±0.2 Kg

Average weight gain 2.3±0.14 Kg

Dialysis Adequacy Kt/V 1.09±0.004 (n=1067, 14.4%)

URR 61.38±0.26 (n=1297, 17.5%)

Thank You

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