Hemoglobin variability does not predict mortality in peritoneal dialysis patients

Chen, Ho-Ching; Chen, Kuan‐Hsing; Lin, Yi‐Hao; Chang, Chee‐Jen; Tian, Ya-Chung; Yang, Chih‐Wei; Hung, Cheng‐Chieh

doi:10.4103/2319-4170.106163

Cited by 3 publications

(1 citation statement)

References 22 publications

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“…Although the mechanism of hemoglobin variability remains uncertain, patients treated with ESA pharmacologic features and dosing of ESA are believed to lead to a cyclical pattern of hemoglobin levels within the recommended range [ 9 ]. A study showed that only about 5% of CKD patients maintained target levels of hemoglobin after a few months of observation [ 10 ]. Another study reported that over 90% of patients experienced hemoglobin cycling [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

Factors Influencing Hemoglobin Variability and Its Association with Mortality in Hemodialysis Patients

Bal

Demirci²,

Karakose

et al. 2018

The Scientific World Journal

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Purpose We aimed to investigate the factors influencing hemoglobin variability with inflammatory and nutritional parameters and its associations with all-cause mortality among hemodialysis patients. Methods One hundred and sixty-nine patients during the entire 12 months were enrolled into the study. Fasting plasma glucose, creatinine, calcium, phosphorus, alkaline phosphatase, parathyroid hormone (PTH), C-reactive protein (CRP), serum iron, serum iron-binding capacity, and transferrin saturation were analyzed. We defined six groups: low, target range, high, low-amplitude fluctuation with low hemoglobin levels, low-amplitude fluctuation with high hemoglobin levels, and high-amplitude fluctuation. Body mass index (BMI), malnutrition-inflammation score (MIS), and Charlson Comorbidity Index were evaluated. Results Hemoglobin variability was significantly correlated with age, platelet count, and number of hospitalization instances and inversely correlated with erythropoietin dose per body surface area. The coefficient of variation of hemoglobin showed a correlation with MIS and ferritin. The absolute level of hemoglobin showed a negative correlation between PTH, CRP, MIS, number of hospitalization instances and a positive correlation with albumin and BMI. High, low, and target-range groups showed survival advantage compared to the other three groups. In regression analysis, age, CRP levels, MIS, and BMI were the predictors of mortality. Conclusion Inflammation and duration of anemia were the major predictors of hemoglobin variability. High-amplitude fluctuation predicts high mortality; on the contrary low-amplitude fluctuations is related to better survival. MIS was independently associated with mortality. This trial is registered with NCT03454906.

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Section: Discussionmentioning

confidence: 99%

Factors Influencing Hemoglobin Variability and Its Association with Mortality in Hemodialysis Patients

Bal

Demirci²,

Karakose

et al. 2018

The Scientific World Journal

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High hemoglobin fluctuation was a protective factor for cardiovascular‐related death in peritoneal dialysis (PD) patients: A retrospective analysis of 232 patients with PD

Liu

Yang

Zhou

et al. 2022

Clinical Laboratory Analysis

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Objectives: This study aimed to investigate the effect of hemoglobin (Hb) fluctuation after dialysis on the prognosis of cardiovascular-related and all-cause deaths in peritoneal dialysis (PD). Methods: According to the Hb fluctuation, patients were divided into low fluctuation group, moderate fluctuation group, and high fluctuation group, and then, the effects of Hb fluctuation after dialysis on the prognosis of cardiovascular-related and all-cause death in PD were analyzed by regression analysis. Results: A total of 232 patients were selected in this study. Compared with the low Hb fluctuation group, the moderate and high fluctuation groups had lower body mass index (BMI), estimated glomerular filtration rate (eGFR), and baseline Hb, and the moderate fluctuation group had less erythropoietin (EPO) and dialysis dose.Compared with survivors, patients with cardiovascular-related and all-cause deaths had lower mean Hb and Hb fluctuation (all p < 0.05). Cox regression analysis showed that before and after adjusting for confounding factors, Hb fluctuation was still independently correlated with cardiovascular prognosis, and higher Hb fluctuation was still a protective factor for cardiovascular-related death in the Hb-substandard group, but there was no significant correlation between Hb fluctuation and all-cause death.Multivariate linear regression analysis revealed that Hb fluctuation was positively correlated with Kt/V and EPO dosage, but negatively correlated with the baseline Hb. Conclusion:High Hb fluctuation was a protective factor for cardiovascular-related death in PD with substandard Hb. Compared with Hb fluctuation, correction of anemia timely and making Hb reaches the standard level had a greater impact on reducing cardiovascular-related death in PD.

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Higher Haemoglobin Level Variation under Treatment with Erythropoitin is Associated with Mortality in Haemodialysis

Beige

Glombig

Wendt

2016

BJPR

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Hemoglobin variability does not predict mortality in peritoneal dialysis patients

Cited by 3 publications

References 22 publications

Factors Influencing Hemoglobin Variability and Its Association with Mortality in Hemodialysis Patients

Factors Influencing Hemoglobin Variability and Its Association with Mortality in Hemodialysis Patients

High hemoglobin fluctuation was a protective factor for cardiovascular‐related death in peritoneal dialysis (PD) patients: A retrospective analysis of 232 patients with PD

Higher Haemoglobin Level Variation under Treatment with Erythropoitin is Associated with Mortality in Haemodialysis

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