Use of 12×/month haemoglobin monitoring with a computer algorithm reduces haemoglobin variability

Abstract

Background. Haemoglobin variability may be associated with increased death. Frequent haemoglobin monitoring may allow earlier detection of trends in haemoglobin slopes, alerting staff to intercurrent events. The more frequent haemoglobin values may provide early evidence of response to erythropoietin (EPO) doses, and allow more appropriate anaemia management. Our objective is to assess whether frequent haemoglobin monitoring data (12×/month) using a computer algorithm (AMIE, Leeds, UK) will reduce haemoglobin variability compared with 1×/month monitoring.Methods. We performed an observational case-control study of 44 unselected patients, comprising one dialysis facility measuring Crit-Line haemoglobin, lab haemoglobin, standard deviation of residuals as surrogate of haemoglobin variability and EPO dosing.Results. Haemoglobin variability and 'percent in target haemoglobin range' significantly improved with 12×/month haemoglobin results using a computer algorithm. There was also a non-significant trend toward for lower EPO doses.Conclusion. Use of a computer algorithm to analyse 12×/month haemoglobin values provides early evidence of haemoglobin trends and allows more appropriate anaemia management, with decreased haemoglobin variability, lower EPO doses and more patients achieving target haemoglobin. © The Author [2009]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.