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Measurement of Tissue Oxygenation Using Near-Infrared Spectroscopy in Patients Undergoing Hemodialysis
Published on: October 2, 2020
Hemoglobin variability in chronic kidney disease: a cross-sectional study
1Department of Medicine, University of Colorado Denver Health Sciences Center, Denver, Colorado 80262, USA. david.spiegel@uchsc.edu
The American Journal of the Medical Sciences
|March 20, 2009
Summary
Erythropoiesis-stimulating agents (ESAs) increase hemoglobin variability in chronic kidney disease (CKD) and dialysis patients. This suggests current ESA administration practices contribute to inconsistent hemoglobin levels.
Area of Science:
- Nephrology
- Hematology
- Anemia Management
Background:
- Maintaining stable hemoglobin (Hgb) levels is a clinical challenge for dialysis patients.
- Erythropoiesis-stimulating agents (ESAs) are used to manage anemia in chronic kidney disease (CKD).
Purpose of the Study:
- To compare hemoglobin variability in CKD and dialysis patients receiving ESAs versus those not receiving ESAs.
- To identify factors contributing to Hgb variability in anemia management.
Main Methods:
- A cross-sectional study analyzing hemoglobin variability using patient-years.
- Hemoglobin variability was quantified as the coefficient of variation (CV) for individual patients.
- Data from 137 CKD patient-years and 350 dialysis patient-years were analyzed.
Main Results:
- Patients with CKD treated with ESAs showed significantly higher Hgb variability (medians: 8.53% for dialysis, 7.37% for non-dialysis) compared to those not treated with ESAs (median: 3.96%).
- P-values were < 0.05 for both comparisons, indicating statistical significance.
- Hemoglobin variability was significantly greater in CKD and hemodialysis patients on ESAs.
Conclusions:
- CKD and hemodialysis patients on ESAs exhibit greater Hgb variability than those not receiving ESAs.
- Current ESA administration practices may be a contributing factor to observed Hgb variability.
- Further research into optimized ESA dosing strategies is warranted.
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