Students Research in Progress
Tuesday, November 14, 2023
08:30 AM–10:00 AM
Abstract
Introduction: Patients undergoing hemodialysis are on many medications to manage end-stage kidney disease (ESKD) complications of hypertension, secondary hyperparathyroidism, and anemia that may require adjustment to improve outcomes and lead to delivery of viable infants. Established data in literature is currently lacking for this patient population. The purpose of this study is to evaluate dosing trends of medications given for such ESKD complications in these patients and evaluate outcomes in goals of therapy.
Research Question or Hypothesis: What pharmacotherapy management trends were observed in pregnant hemodialysis patients that help improve ESKD outcomes?
Study Design: A retrospective data review of pregnant patients receiving hemodialysis between April 2019-May 2021 from the UI Health System.
Methods: Data was collected from the electronic health record using RedCap. The use of erythropoietin stimulating agents (ESA), antihypertensives, phosphorus, calcium, and vitamin D supplementation, red blood cell (RBC) transfusions, emergency room (ER) visits and appropriate laboratory values for each medication category were collected. Microsoft Excel was used to calculate mean and ranges of laboratory values, frequencies of medications administered, RBC administrations, and ER visits.
Results: There were 4 pregnant patients that were on hemodialysis during the study period. All patients required phosphorus, calcium, and vitamin D supplementation with average phosphorus and calcium levels of 3.46 mg/dL and 8.46 mg/dL, respectively. Iron sucrose doses averaged 770 mg/month with a range between 200-1050 mg/month leading to an average transferrin saturation of 26.8%. Epoetin alfa doses ranged between 5,000-30,000 units TIW resulting in an average hemoglobin of 8.28 g/dL. All patients delivered viable preterm infants between 30-36 weeks of gestation.
Conclusion: Based on this data, this patient population requires large doses of monthly iron to maintain goal saturation levels; ESA dosing was variable. Vitamin D and calcium supplementation were required in all patients to maintain appropriate goal levels throughout the pregnancy.
Presenting Author
Thomas Szwajnos BSc Biology, MSc Biotechnology, Doctor of Pharmacy Candidate 2024University of Illinois
Authors
Justyna Mastalerz BSc Psychology, PharmD
UIC College of Pharmacy (M/C 874)
Beatrice Drambarean PharmD, BCPS, BCACP
University of Illinois at Chicago, College of Pharmacy
Stephanie M. Toth-Manikowski MD, MHS
University of Illinois