This information was obtained from the facilities giving dialysis and it was for the first two months only. The study excluded darbepoetin doses as it had only been administered to a few patients. Inpatient EPO doses were not easily determinable as they are not billed differently to Medicare. The use of outpatient EPO only may be underestimating the total use of the medication. The cohort dealt with the biasness by determining the amount of time a patient stayed in hospital. The calculations on the average dose of EPO for every patient per day was by adding the total dose for a whole month then separating it by the number of days of outpatient then multiplying by 30 to get the total of a calendar month. According to the medical reports the study used the right amount of doses. The study was not randomized as it was aimed towards the African-American population. The statistics were right as they compared the characteristics of the baseline by using two tests for categorical variables and n tests for continuous ones; this shows that the study was not randomized.
Results
The study group is of 40,942 patients of 67 years of age who were on hemodialysis. The race of an individual as well as their age, weight and BMI and access type affected the results of the dialysis. The results were clearly stated. Due to distortion in the distribution of EPO doses, the study removed 0.25% of patients on equally parts of the mean. The present participants...
The p values were available in the statistics of ratios.
Discussion
The studies showed that African-Americans need more medication on the ESA dose to get the same results as the white. It is mainly due to concentrations of hemoglobin that are lower in the African-Americans. This means that the African-Americans pay more for the dialysis procedure than the whites. The study shows that African-Americans need these higher doses to attain National Kidney Foundation Kidney Disease Outcomes Quality Initiative suggested targets of hemoglobin. It has been established that African-Americans need roughly 11%, which is 2400 more units of EPO compared to whites. The study also revealed the lack of medical cover by patients, as well.
Conclusion
This journal comprises of a revolutionary study that suggests that outpatient dialysis therapy should include an adjustment for race. African-American require a higher dosage of erythropoiesis stimulating agents than whites to achieve a proportionate hemoglobin level. The tests were conducted with sample of patients the results were tested with a regression analysis. The findings confirm that African-American patients have a more expensive outpatient dialysis therapy than whites. This implies that CMS have a financial disincentive to treat…
