University Of Michigan Nephrology Clinic Anemia Management Orders (Page 2 of 4) in pdf

University Of Michigan Nephrology Clinic Anemia Management Orders Page 2

11. cont every 4-5 week evaluation with adjustments as above until Hgb rise ≤ 1 g/dL/month and Hgb is

within target range; then cont every 4-5 week evaluation with adjustments as needed to maintain Hgb

in target range. If:

Hgb ≤9, notify MD

Hgb ≥9 and < 11, increase current dose by 1 step (~ 25%)

Hgb 11-12.5, maintain therapy

Hgb ≥12.5 and ≤13, decrease dose by 1 step (~ 25%)

Hgb >13, notify M.D. and ask M.D. whether to hold or administer;

if administered, M.D. must complete and sign justification for billing.

Increase dosing interval

12. Patients administering epo analog at home, should report blood pressures

13. Hold Erythropoietin if

Hgb >13

BP>190/110 (notify M.D.)

Adverse drug reaction (notify M.D.)

Other_________

14. See chart for stepwise Erythropoietin dose adjustments/conversions between Epotein alfa (Procrit)

and Darbopoetin alfa (Aranesp)

15. Iron Therapy

M.D. to manage iron therapy as necessary

Iron 325 mg po ___daily____twice daily____three times daily; call M.D. if TSAT < 20% and not

increased after 2 months iron therapy

Iron as above and give venofer as per protocol if TSATS <20% and do not increase after 2 months

iron po supplementation

Physician Signature _________________________ Date:_______________________

R.N. Signature _____________________________Date:_______________________

M.A. Signature ____________________________ Date:______________________

(if patient will be receiving injections at University of Michigan Nephrology Clinic)

University Of Michigan Nephrology Clinic Anemia Management Orders Page 2