Management of Anemia in Chronic Kidney Disease

Researchers, led by Li Cui, MD, conducted a study designed to investigate the correlation between ultrafiltration rate (UFR) and hemoglobin levels and erythropoietin (EPO) response in patients on maintenance hemodialysis. Results of the study were reported in Renal Failure.

The study cohort included 225 patients receiving maintenance hemodialysis, stratified into three groups based on UFR: (1) less than 10 mL/h/kg; (2) 10 to 13 mL/h/kg; and (3) more than 13 mL/h/kg. Clinical parameters and prognosis were compared among the three groups, and multiple linear correlation and regression analyses were conducted.

Compared with the other two groups, the group with UFR less than 10 mL/h/kg was older (P<.05). The group with UFR more than 13 mL/h/kg had the highest single-pool urea Kt/V, monthly EPO dose/weight (P<.001), and EPO resistance index (P<.001). The more than 13 mlL/h/kg group also had the lowest dry weight (P<.001), body mass index (P<.001), hemoglobin (P<.001), hematocrit (P<.05), and red blood cell count (P<.05).

Results of multiple linear regression analysis demonstrated an association between sex, dry weight, UFR, calcium, phosphorus, albumin, and C-reactive protein levels and hemoglobin levels. In multivariate logistic regression analysis, a higher UFR was associated with lower hemoglobin levels. Male sex and higher levels of calcium and albumin were associated with higher levels of hemoglobin.

“High UFR is associated with more severe anemia,” the researchers said. “This study provides new insights into anemia management in patients undergoing hemodialysis.”

Source: Renal Failure