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Abstract: FR-PO0213

Examination of Target Hemoglobin Levels in Patients Undergoing Extended-Hours Hemodialysis

Session Information

Category: Anemia and Iron Metabolism

  • 200 Anemia and Iron Metabolism

Authors

  • Yamada, Takumi, Nagoya Daigaku Daigakuin Igakukei Kenkyuka Igakubu, Nagoya, Aichi Prefecture, Japan
  • Nishibori, Nobuhiro, Nagoya Daigaku Daigakuin Igakukei Kenkyuka Igakubu, Nagoya, Aichi Prefecture, Japan
  • Okazaki, Masaki, Nagoya Daigaku Daigakuin Igakukei Kenkyuka Igakubu, Nagoya, Aichi Prefecture, Japan
  • Ishikawa, Shigefumi, Nagoya Daigaku Daigakuin Igakukei Kenkyuka Igakubu, Nagoya, Aichi Prefecture, Japan
  • Imaizumi, Takahiro, Nagoya Daigaku Daigakuin Igakukei Kenkyuka Igakubu, Nagoya, Aichi Prefecture, Japan
  • Kaneda, Fumika, Iryo Hojin Kamome Clinic, Hitachi, Japan
  • Maruyama, Shoichi, Nagoya Daigaku Daigakuin Igakukei Kenkyuka Igakubu, Nagoya, Aichi Prefecture, Japan
Background

Extended-hours hemodialysis (HD) brings improvement of anemia compared with conventional HD, however, there are few studies investigating optimal hemoglobin (Hb) levels for patients on extended-hours HD. In this study, we examined the optimal Hb levels with the best prognosis for patients on extended-hours HD.

Methods

We conducted a longitudinal study of patients on extended-hours HD from January 2008 to September 2021 and collected laboratory data measured in pre-dialysis samples. Data regarding HD condition and routine blood collections was summarized as mean values for the quarter, and patients were categorized into low Hb (Hb<10) group, middle Hb (10≤Hb<11) group, and high Hb group (11≤Hb). The impact of Hb levels on all-cause mortality was evaluated by Cox regression analysis using a time-dependent model. The nonlinear relationship between Hb levels and all-cause mortality was also evaluated using restricted cubic spline (RCS) analysis.

Results

A total of 448 participants were included in the analysis and the median observation period was 73 months. The percentage of men was 67.6 %, the mean age and Hb levels was 60.4 years, and 10.2 g/dL, respectively. In Cox regression analysis, Hazzard Ratios (HR) of the low Hb group versus the middle Hb group were 1.15 (95%CI 0.75-1.79), and HR of high Hb group versus the middle Hb group were 0.86 (95%CI 0.52-1.43). HR increased in the low Hb group, although the difference was not significant. The RCS analysis similarly shows a trend toward high Hb being acceptable (Figure 1).

Conclusion

The adverse effect of high Hb levels on mortality among HD patients may vary depending on the dialysis modality. In extended-hours HD, the risk tends to be lower in patients with high Hb levels than in conventional HD, which may lead to improve post-dialysis fatigue and maintain activities of daily living.

Digital Object Identifier (DOI)