Journal of Primary Care and General Practice

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Effect of erythropoiesis-stimulating agent therapy in patients receiving palliative care of chronic kidney disease

2nd International Conference on Palliative Care
September 23-24, 2019 | Prague, Czech Republic

Ka Wai Alice Mok, Kai Ming Chow, Cheuk Chun Szeto, Agnes Shin Man Choy, Jack Kit Chung Ng, Jack Kit Chung Ng, Chi Bon Leung and Philip Kam Tao Li

Shatin Hospital, Hong Kong The Chinese University of Hong Kong, Hong Kong

Scientific Tracks Abstracts : J Prim Care Gen Pract


Palliative care program for patients with chronic kidney disease was started a decade ago in Hong Kong, aiming to provide a cross-specialty multidisciplinary palliative care for those who choose not to proceed with dialysis. Anemia is a common complication seen in patients with chronic kidney disease, leading to significant morbidity and mortality, contributing to the top symptom of fatigue among this group of patients. While the benefits of erythropoiesis-stimulating agent (ESA) have been well established for patients with chronic kidney disease receiving dialysis, the effect of this treatment for those who decide for non-dialysis palliative care is less well studied.

Objective: Our center conducted a retrospective observational study to evaluate the effect of ESA in treating anemia of chronic kidney disease among adult patients receiving palliative care who decided not for dialysis in terms of the transfusion burden and hospitalization need. Thirty-nine patients receiving ESA were matched with a control group of 39 patients without ESA.

Results: Over a 1-year observation period, both the transfusion rate and admission rate were found to be significantly lower in the in the ESA group after adjustment for comorbidities. The mean hemoglobin concentration at the end of study period was significantly higher in the ESA group than the control group. No patients in the ESA group had to terminate the drug treatment due to adverse effects.

Conclusion: ESA could lessen the burden of palliative care for patients with chronic kidney disease by reducing transfusion requirement and hospitalization. The option of ESA should be considered in the care plan for patients with chronic kidney disease opted for non-dialysis palliative care.


Ka Wai Alice MOK attained her degree in medicine from the Chinese University of Hong Kong. She completed her specialist training in Palliative Medicine and is the fellow of the Hong Kong College of Physician. She is currently the Associate Consultant of the Palliative Care Unit of Shatin Hospital in Hong Kong and has actively participated in the development of palliative care service for patients with end-stage renal failure. She is a regular invited speaker to talk on the different topics in palliative care by many healthcare societies. She is also the clinical tutor for undergraduate medical students and the lecturer for post-graduate degrees in End-of- Life Care Program of the Chinese University of Hong Kong. 


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