Case management of the anemic patient: epoetin alfa--focus on adequacy of dialysis.

For most patients, therapy with Epoetin alfa reverses anemia and provides them with many benefits, including an improved quality of life. Although some clinicians have expressed concern about the effect of an increased hematocrit on dialysis efficiency, peritoneal dialysis is unaffected, and changes in hemodialysis efficiency are usually not clinically significant. However, close monitoring of the adequacy of dialysis is always warranted. By tracking the results of serum chemistry tests, analyzing trends in urea kinetic modeling, providing patient education, and intervening early when a problem is detected, nurses can help ensure that patients receive the maximum benefit from their treatment regimen.