Comparing the affect of physician treatment management and computer program support (Nefroliz) algorrithyms on hemoglobin variability in chronic hemodialysis patients who receive eritropoetin treatment

Objective: Hemoglobin variability is an important factor for morbidity and mortality in end stage renal disease (ESRD) patients as much as hemoglobin impairment. Using the eritropoesis stimulant agents (ESA) at apropriate dossage and time is the leading cause of basic and fixible causes of hemoglobin variablity. Occurence of standart protocols on treatment may decrease hemoglobin variability. We researched the affect of ESA dosage changes by using standart protocols which were created by computer software.Materials and Methods: 91 patients who receive hemodialysis treatment, hemoglobin and ESA dossages were analysed for four month and compared with latter four month which was created by software support. ESA suggestion was made with using computer software algorithyms by attention on patient?s hemoglobin changes and iron storages. Patiens who need dosage change were enounced to dialysis centers. Physicians were not mandotary to obey to the suggestions.Results: When we compared two phase, in computer support phase mean hemoglobin values were decreased from 10,71 to 10,51, total hemoglobin variability from 88 to 87, upward hemoglobin variability patient count from 34 to 16. On both phases, number of patients who was in target values are %3,2. Total ESA doses and number of changing ESA doses increased on second phase but it is not statistically significant.Conclusion:In this study on second phase even though hemoglobin variability level was reduced mean hemoglobin values pulled out from target. The underlying causes of these results were ESA doses which was suggested by computer wasn?t mandotary, back payment foundation rules and deficiency of model predictive control method. Recent clinical trial results found computer support decreased ESA doses and dose changes, take close the hemoglobin values to target. Furthermore, we hold the belief that using advanced software with larger number of patients, this subject should consider at lenght.Key Words: Hemodialysis, Anemia, Haemoglobin Variability, Eritropoesis Stimulating Agent