Research Information System
INTERNATIONAL JOURNAL OF NEPHROLOGY AND RENOVASCULAR DISEASE, pp.27-42, 2025 (ESCI)
Introduction: Limited data exist regarding treatment patterns and symptom burden of patients with anemia of chronic kidney disease (CKD) in the Middle East, South Africa, and T & uuml;rkiye. Methods: This real-world study explored clinical characteristics, symptom burden, and treatment patterns of patients with anemia of CKD living in the Middle East, South Africa, and T & uuml;rkiye. Physician and patient perceptions of treatment were captured via cross-sectional surveys; patients' clinical characteristics were recorded by retrospective review of medical records. Results: Data were collected from 1788 patients and 217 physicians. A high proportion of patients had never received treatment for their anemia (n = 701, 39.2%); the most common treatment was erythropoietin-stimulating agents (ESAs) + intravenous iron (n = 457, 50.3%). High symptom burden was reported, with lack of energy being the most common symptom (n = 394, 75.6% treated and n = 133, 59.9% non-treated patients). Patients' self-reported symptom burden was higher than physician-reported burden; less agreement was seen for non-dialysis-dependent (NDD) patients (kappa = 0.193, standard deviation [SD]: 0.081) than dialysis-dependent (DD) patients (kappa = 0.442, SD: 0.103). Median hemoglobin thresholds that physicians reported using for initiating treatment (NDD: <10.5 [interquartile range, 9.5-12.0] g/dL; DD: <9.3 [9.0-10.0] g/dL) were higher than actual test levels at treatment initiation (NDD: 9.2 [8.7-10.0] g/dL; DD: 9.0 [8.1-10.0] g/dL). Conclusion: Treatment inertia is apparent despite high symptom burden in the Middle East, South Africa, and T & uuml;rkiye, and disagreement was seen in physician and patient perspectives on symptomology. Improved awareness of this disagreement may help facilitate physician-patient dialogue to improve patient experience.