EXTON, Pa., April 27 /PRNewswire/ -- BioTrends Research Group, Inc. released TreatmentTrends(R): US Nephrology, a syndicated report based on online survey results from over 200 US Nephrologists.

In the ESA market, changes that have occurred seem to have taken place at the product level, while the overall use of ESAs has remained stable compared to the same period last year. Among patients with Chronic Kidney Disease not on dialysis (CKD), market share for Ortho Biotech's Procrit has been trending upward compared to the first quarter of 2008, primarily at the expense of Amgen's Aranesp. And while only about one-third of Nephrologists report that managed care policies have led to a decreased use of ESAs, Aranesp seems to be more negatively impacted by managed care than Procrit.

There have been no significant changes in the use of IV iron in the past year although Nephrologists project significant increases in the use of IV iron among CKD patients in the next three months. American Regent's Venofer continues to hold the position as market leader among CKD patients. In the hemodialysis market, use of Watson's Ferrlecit decreased while Fresenius Medical Care's Venofer, the market leader, experienced share growth year over year. The greatest share growth came from Nephrologists primarily affiliated with FMC. Nephrologists continue to await the approval of AMAG's Feraheme and familiarity with the product is on the rise.

Product shifts have also been the theme in the phosphate binder market where use of Genzyme's Renvela continues to take hold primarily at the expense of Genzyme's Renagel, although the move away from calcium-based binders in both dialysis and CKD continues. Close to 90% of Nephrologists report having at least some hemodialysis patients on Renvela compared to 67% in the previous quarter. Sevelamer is the market leader in dialysis with 55% share. Among CKD patients, sevelamer and FMC's PhosLo each have approximately 36% market share. In both the dialysis and CKD markets, Nephrologists project increases in the use of Renvela and Shire's Fosrenol primarily at the expense of PhosLo and Renagel.

The use of Nutritional Vitamin D is on the rise, particularly among CKD Stage 3 and 4 patients, where Nephrologists report approximately 35% of patients are treated with these agents. Despite this increase, treatment prevalence with Active Vitamin D has remained stable across all patient groups compared to the same period last year. Abbott's Zemplar continues to hold the position of market leader among hemodialysis patients, and in a shift from the same quarter last year when calcitriol was the market leader in CKD, Zemplar now holds that position. Nephrologists report that barriers to increased use of both Zemplar and Genzyme's Hectorol in CKD center around reimbursement and incidences of hypercalcemia and hyperphosphatemia. Amgen's Sensipar continues to be used in less than one third of dialysis patients, although Nephrologists continue to project significant increases in the next three months.

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