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Blood Hemoglobin Change During Maintenance Hemodialysis Sessions.
Hiroyuki Koiki1, Masayuki Tanemoto2,3
1Dialysis Center, Hidakami Chuo Clinic, Iwate, Japan.
Seminars in Dialysis
|March 24, 2026
Summary
Hemoglobin levels can significantly increase during hemodialysis, especially with higher fluid removal. Managing anemia therapy is crucial to mitigate thrombotic risks in maintenance hemodialysis patients.
Area of Science:
- Nephrology
- Hematology
- Cardiovascular Medicine
Background:
- Hemoglobin (Hb) levels often rise during maintenance hemodialysis (MHD) sessions.
- This intradialytic Hb change (ID-HbC) magnitude may correlate with thrombotic risks.
Purpose of the Study:
- To investigate the magnitude of intradialytic Hb change (ID-HbC) during MHD.
- To examine the relationship between ID-HbC and ultrafiltration volume normalized to dry weight (UFV/DW).
Main Methods:
- Analyzed 115 MHD sessions using standard hemodialysis.
- Calculated relative-ID-HbC from pre- and post-dialysis Hb values.
- Correlated relative-ID-HbC with UFV/DW.
Main Results:
- Relative-ID-HbC ranged from -0.037 to 0.324 (median 0.104).
- A significant positive correlation (r=0.50, p<0.001) was found between relative-ID-HbC and UFV/DW.
- In sessions with UFV/DW > 0.05, relative-ID-HbC exceeded 0.2 in approximately one-third of cases.
Conclusions:
- Hb can increase by over 20% in sessions with UFV/DW > 0.05.
- Typical Hb increase is ~3% per 1% increase in UFV/DW.
- Avoid anemia therapy raising pre-dialysis Hb > 10.5 g/dL in MHD patients requiring UFV/DW > 0.05 to reduce thrombotic risks.
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