Abstract：
BACKGROUND: In hemodialysis (HD) patients, anemia is greatly improved due to regular weekly use of iron and erythropoietin (EPO), but a large number of patients still show persistent anemia. We do a survey to elucidate the influencing factors that contribute to the failure of hemoglobin (Hb) to meet the standard and provide epidemiological data reference for promoting the recognition of renal anemia and improving the treatment effect of renal anemia.
METHODS: The clinical data of End-Stage Renal Disease (ESRD) HD patients in 22 tertiary hospital HD centers in Liaoning Province from September 2021 to June 2022 were collected by convenient sampling. According to the 2012 Kidney Disease: Improving Global Outcomes (KDIGO) anemia diagnostic criteria. The standard of Hb compliance: Hb ≥110 g/L is considered as Hb compliant, and Hb <110 g/L as Hb non-compliant. The factors influencing Hb up-to-standard in ESRD HD patients and their correlations were analyzed by comparison between the two groups.
RESULTS: The results of this study showed that among the 1,652 ESRD patients investigated in Liaoning Province, the prevalence rate of anemia was 89.29% (1,475/1,652), and the Hb compliance rate was 46.25% (764/1,652). The Hb compliance rate in maintenance hemodialysis (MHD) patients with different primary diseases was statistically significant (P<0.05). Compared with the Hb non-standard group, the gender, dialysis access, HD frequency, concurrent infection, primary disease of ESRD patients, red blood cell (RBC) count, hematocrit (HCT), mean RBC Hb concentration, mean RBC Hb content, platelet (PLT), albumin (ALB), total protein (TP), serum creatinine (Cr), serum calcium (Ca), serum potassium (K), ferritin (Fer), serum iron (SI), and transferrin (TRE) saturation were significantly different between both groups (P<0.05). Adrenaline was an independent risk factor affecting Hb failure in ESRD patients (OR =1.001, 95% CI: 1.000-1.002); dialysis frequency (OR =0.726, 95% CI: 0.601-0.878), ALB (OR =0.959, 95% CI: 0.929-0.990), TP (OR =0.982, 95% CI: 0.968-0.996), serum Cr (OR =0.959, 95% CI: 0.929-0.999), and SI (OR =0.961, 95% CI: 0.940-0.982) were protective factors affecting Hb failure in ESRD patients (P<0.05). Pearson correlation analysis showed that ALB, TP, serum Cr, serum Ca, serum K, SI, and TRE saturation were positively correlated with Hb (P<0.05).
CONCLUSIONS: The anemia rate of ESRD patients treated with MHD in Liaoning Province is high. Based on the results, increasing the frequency of dialysis can improve anemia. Parathyroid hormone levels need to be controlled.
METHODS: The clinical data of End-Stage Renal Disease (ESRD) HD patients in 22 tertiary hospital HD centers in Liaoning Province from September 2021 to June 2022 were collected by convenient sampling. According to the 2012 Kidney Disease: Improving Global Outcomes (KDIGO) anemia diagnostic criteria. The standard of Hb compliance: Hb ≥110 g/L is considered as Hb compliant, and Hb <110 g/L as Hb non-compliant. The factors influencing Hb up-to-standard in ESRD HD patients and their correlations were analyzed by comparison between the two groups.
RESULTS: The results of this study showed that among the 1,652 ESRD patients investigated in Liaoning Province, the prevalence rate of anemia was 89.29% (1,475/1,652), and the Hb compliance rate was 46.25% (764/1,652). The Hb compliance rate in maintenance hemodialysis (MHD) patients with different primary diseases was statistically significant (P<0.05). Compared with the Hb non-standard group, the gender, dialysis access, HD frequency, concurrent infection, primary disease of ESRD patients, red blood cell (RBC) count, hematocrit (HCT), mean RBC Hb concentration, mean RBC Hb content, platelet (PLT), albumin (ALB), total protein (TP), serum creatinine (Cr), serum calcium (Ca), serum potassium (K), ferritin (Fer), serum iron (SI), and transferrin (TRE) saturation were significantly different between both groups (P<0.05). Adrenaline was an independent risk factor affecting Hb failure in ESRD patients (OR =1.001, 95% CI: 1.000-1.002); dialysis frequency (OR =0.726, 95% CI: 0.601-0.878), ALB (OR =0.959, 95% CI: 0.929-0.990), TP (OR =0.982, 95% CI: 0.968-0.996), serum Cr (OR =0.959, 95% CI: 0.929-0.999), and SI (OR =0.961, 95% CI: 0.940-0.982) were protective factors affecting Hb failure in ESRD patients (P<0.05). Pearson correlation analysis showed that ALB, TP, serum Cr, serum Ca, serum K, SI, and TRE saturation were positively correlated with Hb (P<0.05).
CONCLUSIONS: The anemia rate of ESRD patients treated with MHD in Liaoning Province is high. Based on the results, increasing the frequency of dialysis can improve anemia. Parathyroid hormone levels need to be controlled.
摘要：
背景：在血液透析（HD）患者中，由于每周定期使用铁和促红细胞生成素（EPO），贫血得到了极大的改善，但仍有大量患者表现出持续性贫血。通过调查,阐明血红蛋白(Hb)不达标的影响因素,为促进对肾性贫血的认识,提高肾性贫血的治疗效果提供流行病学数据参考。
方法：采用方便抽样的方法收集2021年9月至2022年6月辽宁省22家三级医院HD中心终末期肾病（ESRD）HD患者的临床资料。根据2012年肾脏疾病：改善全球结果（KDIGO）贫血诊断标准。Hb符合性标准:Hb≥110g/L视为Hb符合性,Hb<110g/L为Hb不合规。比较两组患者的差异,分析影响ESRDHD患者Hb达标的因素及其相关性。
结果：本研究结果表明，在辽宁省调查的1,652例ESRD患者中，贫血患病率为89.29%(1,475/1,652),Hb达标率为46.25%(764/1,652)。不同原发病的维持性血液透析(MHD)患者Hb达标率差异有统计学意义(P<0.05)。与Hb非标准组相比，性别,透析通路,HD频率,并发感染,ESRD患者的原发疾病，红细胞（RBC）计数，血细胞比容(HCT),平均红细胞血红蛋白浓度，平均红细胞血红蛋白含量，血小板(PLT),白蛋白（ALB），总蛋白（TP），血清肌酐(Cr),血清钙（Ca），血清钾（K），铁蛋白（Fer），血清铁（SI），转铁蛋白（TRE）饱和度两组间差异有统计学意义（P<0.05）。肾上腺素是影响ESRD患者Hb衰竭的独立危险因素(OR=1.001,95%CI:1.000-1.002);透析频率(OR=0.726,95%CI:0.601-0.878),ALB（OR=0.959，95%CI：0.929-0.990），TP（OR=0.982，95%CI：0.968-0.996），血清Cr（OR=0.959，95%CI：0.929-0.999），SI(OR=0.961,95%CI:0.940~0.982)是影响ESRD患者Hb衰竭的保护因素(P<0.05)。Pearson相关分析表明,ALB,TP,血清Cr,血清Ca,血清K,SI,TRE饱和度与Hb呈正相关(P<0.05)。
结论：辽宁省接受MHD治疗的ESRD患者贫血率高。根据结果,增加透析频率可以改善贫血。甲状旁腺激素水平需要控制。
方法：采用方便抽样的方法收集2021年9月至2022年6月辽宁省22家三级医院HD中心终末期肾病（ESRD）HD患者的临床资料。根据2012年肾脏疾病：改善全球结果（KDIGO）贫血诊断标准。Hb符合性标准:Hb≥110g/L视为Hb符合性,Hb<110g/L为Hb不合规。比较两组患者的差异,分析影响ESRDHD患者Hb达标的因素及其相关性。
结果：本研究结果表明，在辽宁省调查的1,652例ESRD患者中，贫血患病率为89.29%(1,475/1,652),Hb达标率为46.25%(764/1,652)。不同原发病的维持性血液透析(MHD)患者Hb达标率差异有统计学意义(P<0.05)。与Hb非标准组相比，性别,透析通路,HD频率,并发感染,ESRD患者的原发疾病，红细胞（RBC）计数，血细胞比容(HCT),平均红细胞血红蛋白浓度，平均红细胞血红蛋白含量，血小板(PLT),白蛋白（ALB），总蛋白（TP），血清肌酐(Cr),血清钙（Ca），血清钾（K），铁蛋白（Fer），血清铁（SI），转铁蛋白（TRE）饱和度两组间差异有统计学意义（P<0.05）。肾上腺素是影响ESRD患者Hb衰竭的独立危险因素(OR=1.001,95%CI:1.000-1.002);透析频率(OR=0.726,95%CI:0.601-0.878),ALB（OR=0.959，95%CI：0.929-0.990），TP（OR=0.982，95%CI：0.968-0.996），血清Cr（OR=0.959，95%CI：0.929-0.999），SI(OR=0.961,95%CI:0.940~0.982)是影响ESRD患者Hb衰竭的保护因素(P<0.05)。Pearson相关分析表明,ALB,TP,血清Cr,血清Ca,血清K,SI,TRE饱和度与Hb呈正相关(P<0.05)。
结论：辽宁省接受MHD治疗的ESRD患者贫血率高。根据结果,增加透析频率可以改善贫血。甲状旁腺激素水平需要控制。
