At the same time, the properties and modalities for the measurement of those parameters were defined. Simultaneously, some research drafts in the field were considered. In the domain of the anaemia observed in chronic kidney disease, the investigation of the factors leading to sub-optimal management of anaemia in the dialysis and the transplant patients populations appeared as the most appealing. Two study protocols were set-up:

1. Strategies of anaemia correction and use of erythropoiesis stimulating agents in dialysis patients

This study wants to evaluate  in a multi-centre, cross-sectional and prospective observational study the prevalence and distribution of anaemia and its treatment in a large European dialysis population. In the participating units, all the patients treated by dialysis (HD + PD) for at least 6 months will be evaluated. During a 3-months observation period, treatment by  erythropoiesis stimulating agents (ESA) and parameters potentially related to ESA hypo-responsiveness would be investigated. Routine center policies for anaemia  surveillance and management and administrative regulations will also be recorded. One of the study aims is to reveal the factors that in clinical practice induce sub-optimal use of these expensive drugs.

2. Prevalence and management of anaemia in renal transplant patients

Data on the management of anaemia in transplant patients are scarce, and the available evidence seems to indicate that transplant patients, despite having CKD stage 3, are mostly not considered as CKD patients. Physicians have a low awareness of renal anaemia in these patients or are reluctant to start ESA. This multi-centre cross-sectional study will evaluate the prevalence and distribution of anaemia as well as its management in a large European renal transplant  population. In the participating units, all surviving renal transplant patients with at least one-year of follow-up, will be investigated. Parameters related to anaemia, renal function, use of ESA, immunosuppressive regimen, and other relevant factors will be recorded in a given time period. Routine transplant centre policies for anaemia surveillance and management, and administrative regulations will also be investigated.

These 2 studies will allow a deeper insight to the role of the various factors that hamper optimal correction of anaemia in the European dialysis and transplant populations. In addition, used as part of a continuous quality improvement program, the return of the study results to the participating centres will allow them to optimize their anaemia management at the levels of individual patient and centre.

 

Jean-Pierre Wauters

on behalf of the QUEST Anaemia Working Group