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The relation between hemoglobin variability and carotid intima-media thickness in chronic hemodialysis patients

Safa Ersen Ganidagli1, Orcun Altunoren2, Ertuğrul Erken3

  • 1Faculty of Medicine, Internal Medicine Department, Kahramanmaras Sutcu Imam University, Kahramanmaraş, Turkey.

International Urology and Nephrology
|July 17, 2017
PubMed

Insights

Hemoglobin variability is linked to increased carotid intima-media thickness (CIMT) in hemodialysis patients. Patients with high hemoglobin variability showed significantly higher CIMT, suggesting a potential risk factor for atherosclerosis.

Area of Science:

  • Nephrology
  • Cardiology
  • Vascular Biology

Background:

  • Hemoglobin variability is a frequent complication in hemodialysis (HD) patients.
  • Previous research linked hemoglobin variability to left ventricular mass index.
  • The relationship between hemoglobin variability and carotid intima-media thickness (CIMT) requires further investigation.

Purpose of the Study:

  • To investigate the association between hemoglobin variability and CIMT in patients undergoing maintenance hemodialysis.
  • To determine if different hemoglobin trajectories correlate with varying levels of CIMT.

Main Methods:

  • Retrospective analysis of 12-month hemoglobin (Hb) data from 135 HD patients.
  • Classification of Hb levels (Low, Normal, High) and Hb trajectories (Low-Normal, Normal-High, Low-High).
  • Measurement of common carotid artery intima-media thickness (CIMT) and comparison across Hb trajectory groups.

Main Results:

  • The Low-High (LH) hemoglobin trajectory group exhibited significantly higher mean CIMT (0.744 ± 0.139 mm) compared to Low-Normal (LN) (0.601 ± 0.107 mm) and Normal-High (NH) (0.604 ± 0.134 mm) groups (p < 0.001).
  • Demographic and laboratory features, including age, diabetes, hypertension, and cardiovascular disease, were similar across the groups.
  • No significant differences were observed in duration of hemodialysis, adequacy, serum lipids, or calcium-x-phosphate products.

Conclusions:

  • The study demonstrates a significant association between high hemoglobin variability (LH group) and increased CIMT in hemodialysis patients.
  • This finding suggests that hemoglobin variability may be an independent risk factor for atherosclerosis in this population.
  • This is the first study to report a link between hemoglobin variability and elevated CIMT in hemodialysis patients.
Abstract

Keywords:
AnemiaCarotid intima-media thicknessEnd-stage renal diseaseHemodialysisHemoglobin variability

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