The European Survey on Anaemia Management (ESAM): Indicators of current practices of anaemia care in patients with end-stage renal disease

I. C. Macdougall, W. H. Hörl, C. Jacobs, F. Valderrábano, I. Parrondo, I. L. Abraham, A. E. Peterson

Research output: Contribution to journalReview article


There is persistent variability in the practice patterns of anaemia management in patients with end-stage renal disease. In an effort to document existing practice patterns before the introduction of the European Best Practice Guidelines (EBPG), the European Survey on Anaemia Management (ESAM) was launched in 14 Western European countries. Data were collected longitudinally for 6 months. Findings are reported on 14 527 patients, of which 13 121 (90.3%) were receiving haemodialysis and 1406 (9.7%) were receiving peritoneal dialysis. The ESAM found that epoetin treatment is most often initiated after dialysis has begun, with haemoglobin (Hb) levels (mean = 8.7 g/dl) lower than the EBPG recommendation. For target Hb, the vast majority of patients were allocated values at or exceeding the EBPG recommended level, yet in only 53.6% of patients were these targets reached at 6 months. During any given month of the survey, between 15% and 22% of haemodialysis patients and between 41% and 45% of peritoneal dialysis patients had absolute iron deficiency; however, almost 19% of haemodialysis patients and 34% of peritoneal dialysis patients received no iron supplementation during the 6-month study. The ESAM documents the significant shortfall between EBPG recommendations and de facto clinical management of anaemia in end-stage renal disease. Patients are being treated with epoetin too late in the course of their anaemia, iron supplementation is underused and target Hb levels are not being achieved.

Original languageEnglish (US)
Pages (from-to)3-14
Number of pages12
JournalErythropoiesis: New Dimensions in the Treatment of Anaemia
Issue number1
StatePublished - Jan 1 2001


ASJC Scopus subject areas

  • Hematology

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