Original Investigations: Dialysis TherapiesInfluence of the cyclic variation of hydration status on hemoglobin levels in hemodialysis patients*,**
Section snippets
Study A
This study aims to evaluate the impact on Hb levels of different degrees of fluid retention after the long and short interdialytic periods. Anuric (ie, urinary output < 200 mL in the long interval) HD patients were studied in the three consecutive HD sessions during 1 week of treatment (HD-1, session of the week performed after the long interdialytic interval; HD-2 and HD-3, subsequent sessions performed after the two short intervals). We selected patients treated for at least 1 year with
Study A
The study was performed in 49 patients (21 men, 28 women) with a mean age of 60.6 ± 2.2 years and a body mass index of 23.2 ± 0.5 kg/m2. Achievement of dry weight, suggested on a clinical basis, was testified by inferior vena cava diameter values (8.9 ± 0.7 mm/m2) and BIA-derived percent total body water (%TBW; 53.3% ± 1.2%) obtained at the end of the last HD session before the study week.
Delivered Kt/V dose in HD-1 was 1.35 ± 0.03; this value did not change during the study week. The duration
Discussion
This prospective study documents the effects of variations in hydration status and plasma refilling on variability in Hb levels in maintenance HD patients. Results constitute novel information because no previous work has monitored changes in Hb values in relation to different amounts of fluid removed in the three consecutive HD sessions of the week. Similarly, no investigator has estimated the effect on Hb concentration of post-HD plasma refilling.
In study A, the comparison between the mean Hb
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Interdialytic Weight Gain Effects on Hemoglobin Concentration and Cardiovascular Events
2020, Kidney International ReportsCitation Excerpt :True hemoglobin concentration cannot be measured in patients undergoing HD. Predialysis hemoglobin concentration is affected by IDWG, and postdialysis hemoglobin concentration is affected by the balance between ultrafiltration volume and refill volume.23–25 In current predialysis measurement practices, consideration of IDWG in the interpretation of predialysis hemoglobin concentration may contribute to reduction of cardiovascular event risk even if true hemoglobin concentration in patients receiving HD is unknown.
Clinical Practice Guidelines for evaluation of anemia
2008, Kidney InternationalCitation Excerpt :The recommendation to evaluate anemia in hemodialysis-chronic kidney disease patients using predialysis hemoglobin levels is based on two considerations. First, postdialysis hemoglobin levels vary depending on the amount of fluid removed during a hemodialysis session, with an average increase in hemoglobin of 3–4 g for every liter of volume ultrafiltered.24,25 Second, there is no evidence providing associations between postdialysis hemoglobin levels and clinical outcomes.
Necessity of adjusting the blood hemoglobin target owing to interdialytic weight gain in patients on maintenance hemodialysis
2023, Hemodialysis International
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