Improving Anemia Outcomes for Erythropoeitin Stimulating Agent Hyporesponsive Hemodialysis Patients
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Authors
Charla L. R. Naone
Issue Date
2025
Type
Thesis
Language
Keywords
Nursing
Alternative Title
Abstract
Purpose: To evaluate the effectiveness of the Supplemental Hyporesponse to ESA Checklist in managing anemia among hemodialysis patients who are hyporesponsive to erythropoiesisstimulating agents (ESAs). The checklist aims to improve hemoglobin levels and optimize anemia management by identifying and addressing underlying causes of ESA hyporesponsiveness. Background and Significance: Anemia is a common and serious complication in patients with end-stage renal disease (ESRD), contributing to reduced quality of life, cardiovascular disease, and increased mortality (Bae et al., 2019). While ESA therapy is standard, many patients exhibit suboptimal responses, often requiring high doses that raise cardiovascular risk (Shah et al., 2020) Intervention and Implementation Plan: The intervention was implemented using a multidisciplinary team including nurses and nurse practitioners. Prior to implementation staff undertook a comprehensive training session. The checklist was used to monitor and adjust treatment for hyporesponsive patients. Data collected included hemoglobin levels, ESA dosages, referrals, and post-intervention survey responses evaluating the checklist’s utility. Results and Implications: Use of the checklist was associated with increased hemoglobin levels and reduced ESA doses in most patients. This targeted, individualized approach to anemia management enhanced clinical decision-making and may reduce cardiovascular risks. The positive results support the broader adoption of the checklist to improve anemia outcomes across the ESRD population in other dialysis settings.