Iron Deficiency Anemia Occurs in Up to 8.42% of Renal Failure Discharges in Pennsylvania Hospitals

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In Iron Deficiency Anemia (IDA)

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By: James Pitt  Jun. 14, 2018

Anemia is a common complication of chronic kidney disease and renal failure. Gaweda et. al (2014) write that “Anemia in chronic kidney disease (CKD) is primarily a consequence of insufficient erythropoietin (EPO) production.” EPO is a hormone produced primarily in the kidneys, which stimulates red blood cell production in bone marrow. Recombinant human EPO (rHuEPO) can help make up for the lack of EPO production, but rHuEPO alone may not alleviate anemia in all patients, because other components (like iron) are also necessary for normal red blood cell production. According to Nissenson and Strobos (1999), “Deficient available iron is the most common cause of initial poor response to rHuEPO.”

Dexur analysts examined the incidence of iron deficiency anemia (IDA) in renal failure patients in Pennsylvania. The sample was hospital-level data from 2013-2016 CMS inpatient discharges. The lowest rate of IDA in renal failure discharges was 4.11%, at the Hospital of the University of Pennsylvania (Philadelphia, PA). This figure more than doubled at Penn State Milton S. Hershey Medical Center (Hershey, PA), where 8.42% of renal failure discharges involved IDA.

There was little evidence of a relationship between complication severity and the presence of IDA. Patients with renal failure with major complications or comorbidities (DRG 682) had IDA at comparable rates to patients with non-major complications or comorbidities (DRG 683). The highest rate of IDA in patients with major complications was 10.79%, at Geisinger Community Medical Center (Scranton, PA). The lowest was 5.13%, at UPMC Altoona Hospital (Altoona, PA). The rate of IDA in patients with renal failure with non-major complications varied in a similar range, from 5.81% at UPMC Hamot (Erie, PA) to 9.15% at Penn State Milton S Hershey Medical Center (Hershey, PA).

DEXUR PRO MEMBERS GET ACCESS TO:

1. Total discharges
2. Total discharges with iron deficiency anemia
3. IDA incidence rates (%)

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From 2013-2016 for DRGs 682, 683, 684, and for renal failure overall, at the below hospitals:

1. Aria Health - Torresdale (Philadelphia, PA)
2. Geisinger Community Medical Center (Scranton, PA)
3. Guthrie Robert Packer Hospital (Sayre, PA)
4. Hospital Of University Of Pennsylvania (Philadelphia, PA)
5. Lehigh Valley Hospital - Muhlenberg (Bethlehem, PA)
6. Penn State Milton S Hershey Medical Center (Hershey, PA)
7. St Luke's University Hospital Bethlehem (Bethlehem, PA)
8. UPMC Altoona Hospital (Altoona, PA)
9. UPMC Hamot (Erie, PA)
10. UPMC Presbyterian (Pittsburgh, PA)

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