Some Dialysis Centers Overtreat Anemia: Study
Mar. 23 -- TUESDAY, April 17 (HealthDay News) -- People receiving dialysis at large for-profit dialysis centers may be getting over-treated for anemia, a common complication in people with kidney disease, and that might be putting their health at risk, a new study contends.
The typical hospital-based dialysis center administered an average dose of 16,188 units per week of epoetin, a drug that helps correct anemia. Conversely, for-profit chain facilities administered and average of 20,838 units a week. For-profit facilities used an average of about 3,300 units per week more than nonprofit dialysis centers, according to the study.
"Basically what we found in the area of anemia management is there are wide differences in practice," said study author Mae Thamer, a senior associate at the Medical Technology and Practice Patterns Institute in Bethesda, Md. "We found that large for-profit dialysis centers were much more likely to prescribe the highest doses of epoetin."
The problem, Thamer explained, is that this practice may lead to serious complications, including an increased risk of death for patients who receive too much epoetin.
The findings are published in the April 18 issue of the Journal of the American Medical Association.
So, why would centers overuse the medication? Possibly because it's one of the few treatments for end-stage kidney disease that's readily reimbursed by Medicare. In fact, epoetin comprised 11 percent of all Medicare costs for end-stage kidney disease, with almost $2 billion in payouts for the drug in 2004, according to the study. Up to 25 percent of a dialysis center's profits may come from epoetin, according to an accompanying editorial in the journal.
Epoetin is a synthetic version of a hormone normally produced by the kidneys called erythropoietin. This hormone stimulates the bone marrow to produce red blood cells, which carry oxygen to all of the other cells in the body. People with kidney disease don't always produce enough erythropoietin, and anemia -- a shortage of red blood cells -- can result.
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