Clinician’s Perspectives on the Management of Anemia in Chronic Kidney Disease in Indian Settings

Abstract

Objective: The study aims to gather clinicians’ perspectives on the management of anemia in patients with chronic kidney disease (CKD). Methods: In this cross-sectional study, a 23-item, multiple-response questionnaire gathered expert opinion on current practices, clinical observations, and experiences related to the management of anemia in CKD patients in India. The survey respondents were specialists with expertise in managing CKD. Data were analysed using descriptive statistics. Results: The study included 288 clinicians. Inadequate production of erythropoietin by the kidneys was the primary cause of anemia in the majority of patients with CKD, as reported by 36% of respondents. More than half (55.56%) of the respondents reported that the preferred iron supplementation for patients with hemoglobin (Hb) <9% was the intravenous (IV) route, while 42% reported that tablets were the preferred iron supplementation. Oral iron supplements were the most preferred treatment option for anemia in CKD patients, as indicated by 39% of the clinicians, while 36% of them stated erythropoiesis-stimulating agents (ESAs) were the preferred treatment option for CKD. A majority (78.82%) of the participants stated ferric carboxymaltose as their preferred IV iron formulation. About 56% of the clinicians opined that highly bioavailable liposomal iron bypasses the extremely restrictive normal intestinal barriers and achieves a much higher plasma iron concentration, were true regarding liposomal iron. Conclusion: This study reported that reduced erythropoietin production was the leading cause of anemia, with iron therapy and ESAs as the primary treatments. IV iron was preferred for more severe anemia, while oral iron remained widely used. Liposomal iron was the preferred choice due to its perceived bioavailability.