Impact of hemoglobin variability on cardiovascular mortality in maintenance hemodialysis patients

Purpose Although the association between anemia and cardiovascular mortality in hemodialysis patients is well established, whether hemoglobin variability (Hgb-Var) affects the prognosis remains unclear. We aimed to evaluate the association between Hgb-Var and cardiovascular mortality in Chinese hemo...

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Bibliographic Details
Published in:International urology and nephrology 2018-09, Vol.50 (9), p.1703-1712
Main Authors: Lin, Fu-Jun, Zhang, Xi, Huang, Lu-Sheng, Ji, Gang, Huang, Hai-Dong, Xie, Yun, Jiang, Geng-Ru, Zhou, Xin, Lu, Wei
Format: Article
Language:English
Subjects:
Adult
Aged
Cardiovascular diseases
Cardiovascular Diseases - blood
Cardiovascular Diseases - mortality
Cardiovascular Diseases - physiopathology
China - epidemiology
Echocardiography
Female
Health risk assessment
Heart
Heart Ventricles - diagnostic imaging
Heart Ventricles - physiopathology
Hemodialysis
Hemoglobin
Hemoglobins - metabolism
Humans
Kaplan-Meier Estimate
Kidney Failure, Chronic - blood
Kidney Failure, Chronic - therapy
Male
Medicine
Medicine & Public Health
Middle Aged
Mortality
Nephrology
Nephrology - Original Paper
Prognosis
Proportional Hazards Models
Regression analysis
Renal Dialysis
Retrospective Studies
Stroke Volume
Urology
Ventricle
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Summary:Purpose Although the association between anemia and cardiovascular mortality in hemodialysis patients is well established, whether hemoglobin variability (Hgb-Var) affects the prognosis remains unclear. We aimed to evaluate the association between Hgb-Var and cardiovascular mortality in Chinese hemodialysis patients. Methods This retrospective study included 252 patients starting hemodialysis in Xin Hua Hospital between January 2009 and December 2015. Patients were divided into three tertiles based on Hgb-Var, as reflected by SD Hgb mean , SD Hgb range , and Hgb deflection during a 12-month evaluation period after hemodialysis initiation. Left ventricular ejection fraction (EF) and left ventricular mass index (LVMI) were evaluated by echocardiography. Information on cardiovascular deaths occurred by December 2017 was collected. Multivariate Cox regression models were constructed to evaluate the association between Hgb-Var and cardiovascular mortality. Results A total of 75 deaths and 52 cardiovascular deaths occurred during the 47-month follow-up (range 29.5–70). Under multivariate regression, the subgroup with the highest Hgb-Var had a higher risk of cardiovascular mortality after adjusting for relevant factors (HR vs. lowest SD Hgb mean : 9.15, 95% CI 2.82, 29.693, P  
ISSN:0301-1623
1573-2584
DOI:10.1007/s11255-018-1919-5