DENVER—A significant proportion of patients with CKD but not on dialysis (CKD-NOD) with new-onset moderately severe anemia do not receive treatment with iron or erythropoiesis-stimulating agents (ESAs), study findings suggest.

Of those who are treated, approximately half receive iron therapy alone, with oral iron more common.

The findings come from a study of 1,546 CKD-NOD patients with new-onset anemia (hemoglobin below 10 g/dL) at Geisinger Medical Center in Danville, PA. They had a mean age of 74 years. The mean follow up was 3.4 years.

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Of the 1,546 patients, 753 (48.7%) received no therapy, 230 (15%) received ESAs alone, , 347 (22%) received iron alone, and 216 (14%) were treated with both ESAs and iron.

H. Lester Kirchner, PhD, of the Center for Health Research at Geisinger, and colleagues found that baseline transferrin saturation was significantly lower among iron users than non-users. ESA use was significantly more common among iron users than non-users. Compared with non-users, patients receiving iron monotherapy had a 67% increased odds of ESA use and those receiving dual iron treatment (intravenous and oral) had a greater than five-fold increased odds of ESA use.