RBC transfusions among U.S. hemodialysis patients decreased more than twofold from 1992 to 2005, researchers reported in the American Journal of Kidney Diseases (2008; published online ahead of print).

Most of the decrease, they noted, occurred in the first five years following introduction of erythropoietin.

Raw transfusion rates decreased among dialysis patients in both outpatient and inpatient settings from 535/1,000 patient-years in 1992 to 263.65/1,000 patient-years in 2005, according to the data. Adjusted rates showed comparable declines. This phenomenon, the researchers said, could not be explained by changes in case mix.

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With respect to study limitations, the investigators noted that cause, effect, and confounding cannot be separated because of the observational nature of the study. In addition, the accuracy of blood transfusion billing data—which were obtained from Medicare Part A and Part B files—is unknown.