OBJECTIVES : Anaemia, a common complication of chronic kidney disease (CKD), is associated with poor outcomes. This study aimed to describe current routine anaemia management in dialysis-dependent (DD) CKD patients in France.

METHODS : This longitudinal, observational study included retrospective electronic medical records (the MEDIAL database) for DD-CKD patients aged ≥18 years managed in French hospitals, 01/01/2016–31/12/2016 (inclusion period). The ‘CKD anaemia’ cohort comprised DD-CKD patients with at least one anaemic marker (haemoglobin <13 g/dL for males, <12 g/dL for females; record of any anaemia treatment; and/or anaemia diagnosis [ICD10 code D63.8]). Index date (ID) was the date of first anaemic marker during the inclusion period. One-year patient medical history prior to ID and ≤2-year follow-up data were collected. The primary objective was to describe treatment (erythropoiesis-stimulating agents [ESAs], oral/IV iron) of CKD-related anaemia.

RESULTS : Of 1729 DD-CKD patients in the database, 1632 were eligible for inclusion; of these, 1286 (78.8%) had anaemia. Mean (SD) age was 70.4 (14.6) years. At ID, 83.1% (1069/1286) of the CKD anaemia cohort received ESAs, 77.4% (995/1286) IV iron, 0.2% (2/1286) oral iron, and 4.6% (59/1286) no treatment. The most frequent treatment combinations were IV iron + ESA (65.1%, 837/1286) and ESA only (18.0%, 231/1286). During 2 years’ follow-up, 55.9% (719/1286) had ≥1 treatment change (37.4% [313/837] in the IV iron + ESA group; 96.1% [222/231] in the ESA only group); of these, most (85.8%, 617/719) had only one treatment change. Among first treatment changes, almost all were either add-ons (49.4%, 355/719) or stopping treatment (50.3%, 362/719). Only 0.3% (2/719) switched treatments. Treatments added were split between ESAs (40.6%, 144/355) and iron (59.4%, 211/355). Among discontinued treatments, most were ESAs (83.1%, 301/362).

CONCLUSIONS : In France, IV iron + ESA was the predominant treatment regimen for DD-CKD-related anaemia. Under current care standards, significant unmet needs remain.