Strategic decision unrelated to safety or efficacy

This 2 arm study will compare 'time and motion' (provider time spent on anemia management) and effect on hemoglobin (Hb) levels, of methoxy polyethylene glycol-epoetin beta (Mircera) and epoetin alfa, in anemic patients with chronic kidney disease (CKD) on hemodialysis. Patients stable on intravenous (iv) epoetin alfa will be randomized either to receive standard of care therapy (epoetin alfa (iv) 3 times weekly), or to receive Mircera 120-360 micrograms (iv), monthly. After a titration period, average time spent on anemia treatment over a 3 month period will be evaluated. The anticipated time on study treatment is 3-12 months, and the target sample size is 100-500 individuals.

Inclusion Criteria:

• adult patients, >=18 years of age;
• CKD (stage V) on outpatient hemodialysis therapy for >= 3 months;
• CKD-related anemia treated with epoetin alfa iv 3x/week for >= 3 months;
• average hemoglobin (Hb) 10-12 g/dL over last 3 months.

Exclusion Criteria:

• failed renal transplant within 12 months prior to screening;
• poorly controlled hypertension;
• previous treatment with Mircera.