Assessment of an Anemia Model Predictive Controller for Anemia Management in Hemodialysis Patients

Inclusion Criteria: * Age ≥18 years * Ability to give written informed consent to the study * End-stage renal disease treated with thrice-weekly hemodialysis for at least 180 days preceding enrollment * Receiving intradialytic Crit-Line® monitoring, with available Crit-Line® data going back at least 180 days from the date of enrollment * Laboratory Hgb data going back at least 180 days from the date of enrollment * On average, Hgb values available from at least 2 treatments per week (from either source, Crit-Line® or laboratory) during the past 180 days preceding enrollment * Renal anemia treated with intravenous Mircera®, with at least 2 Mircera® dose administrations during the 150 days preceding enrollment * On an active Mircera® anemia management algorithm order during the 180 days preceding enrollment * Exclusively on Mircera® (no other ESAs) during the 180 days preceding enrollment * Pattern of Hgb cycling as defined above during the 180 days preceding enrollment Exclusion Criteria: * Having received the maximum Mircera® dose (225 µg every other week) consistently throughout the 90 days preceding enrollment * Hospitalization for more than 10 days during the 30 days preceding enrollment * Severe iron deficiency (TSAT \<20%, ferritin \<100 ng/mL) in the most recent routine blood work prior to enrollment * Any known cause of ESA resistance other than iron deficiency and inflammatory states (e.g. hematologic malignancies, hypersplenism, antibody mediated pure red cell aplasia) * Simultaneous participation in another clinical study that may impact anemia management or the outcomes of this trial * Inability to communicate in English or Spanish