[Treatment of anemia in dialysis patients in France (1998-1999) (Study by ESAM-France)]

This paper reports the results observed in 3934 French patients who have been included in the prospective ESAM study (European Survey on anemia management) conducted between september 1998 and march 1999 in 14 european countries. This survey aimed at investigating the profile of the anemia and its treatment with recombinant erythropoietin (EPO) in patients treated with maintenance hemodialysis (90.5%) or peritoneal dialysis (9.5%) in 205 french centers prior to the release of the European Guidelines for treatment of renal anemia (EBPG). Only 7.9% of the HD patients and 24.7% of those treated with PD received EPO prior to start of dialysis therapy. At inception of the study (during which all patients received EPO, (before, at time of, or after start dialysis) only 40.2% of patients had an Hb concentration equal to or higher than 11 g/dl (median 10.6 g/dl). At the end of the six month's study this percentage had risen only by 3.6% (43.6%, median Hb 10.8 g/dl). The prescription and monitoring of the effects of iron salts supplementation appeared frequently unsatisfactory and account for a large part for these somewhat disappointing results. No statistically significant adverse effect nor influence on the short time mortality rate attributable to the administration of EPO is evidenced for this population of patients in this study.