Evaluation of a service reconfiguration for managing intravenous iron supplementation in non-haemodialysis patients with chronic renal failure

摘要

There is a growing population of patients with chronic kidney disease. Guidelines, outlining 'best care', promote the use of early intervention for anaemia management. This presents an additional funding pressure and imposes a significantly increased workload on individual renal units.At Sunderland Royal Infirmary, iron sucrose was routinely administered to renal replacement patients, to both those receiving haemodialysis and those on continuous ambulatory peritoneal dialysis (CAPD). In addition, anaemia management of the expanding cohort of pre-dialysis patients resulted in a growing number of these individuals being administeredintravenous iron supplementation. This additional, and growing workload, led to an increased waiting list and waiting times for treatment. It was recognised that to provide optimal iron replacement, it was necessary for patients to make repeated weekly visits to the clinic for administration of their iron infusions. Compliance was often poor, and optimal iron management was difficult to achieve.