This was a before-and-after study, carried out in a single centre. The duration of the follow-up was 6 months. The number of patients who did not complete the study (loss to follow-up) was not reported. The study was completed in a real-life clinical setting in which the nephrologist, staff, and patients were aware of all therapies being given. No attempts were made to alter prescribing patterns, except to encourage the use of dosage protocols for epoetin alfa and iron dextran.
The epoetin alfa dosage protocol that was in place before this study, was as follows:
for hematocrit above 37%, reduce dosage by 50% if hematocrit increases by 4% or more, and reduce dosage by 25% if hematocrit increases by 3% or more;
for hematocrit below 30%, ferritin concentration below 100ng/mL, and transferrin saturation greater than 20%, initiate iron dextran protocol;
for hematocrit below 30%, ferritin concentration over 100ng/mL, and transferrin saturation above 20%, increase dosage by 50% to a maximum of 10,000 units three times a week.
Before the initiation of the iron dextran protocol at the end of the six-month baseline period, iron dextran was administered randomly at doses ranging from a total of 100 to 500mg. Blood prescribing was at the nephrologists' discretion throughout the study.