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Titolo Dialysis Facility Ownership and Epoetin Dosing in Hemodialysis Patients: A Dialysis Provider?s Perspective
Autore I.M. Lazarus, R.M. Hakim
Referenza American Journal of Kidney Diseases 2007; 50 (3): 366-370
Contenuto Together with the other articles in this section, the following is a commentary on Thamer M, Zhang Y, Kaufman J, Cotter D, Dong F, Hernan MA: Dialysis facility ownership and epoetin dosing in patients receiving hemodialysis. JAMA 297:1667-1674, 2007. THE CHALLENGE OF ANALYZING HEMOGLOBIN LEVELS AND EPOETIN DOSES ?Lies, Damned Lies, and Statistics? Attributed to Benjamin Disraeli and popularized by Mark Twain The article by Thamer et al1 and the accompanying editorial by Coyne2 raise the question of whether the profit status of dialysis facilities is a principal factor influencing a higher hemoglobin level or higher erythropoietin dose. For the reasons outlined below, including flaws in the analysis of data and incomplete and biased interpretation of the results, we disagree with this assertion in the Thamer et al article; further, we take issue with the inference made in the Coyne editorial and argue that appropriate anemia treatment protocols in for-profit and not-for-profit dialysis facilities are essential to good patient care.
Data 21.09.2007
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