Increase in post‐dialysis hemoglobin can be out of proportion and unrelated to ultrafiltration

Abstract

OBJECTIVEThe objective of this study was to compare pre‐dialysis and post‐dialysis hemoglobin (Hgb) and ultrafiltration in hemodialysis patients. Factors influencing Hgb are not well understood.METHODSPre‐dialysis and post‐dialysis Hgb and weight were measured in 133 hemodialysis patients. Absolute and percentage change in Hgb (%ΔHgb) and percent change in body weight (%ΔBW) were determined for that treatment. Patients were divided into 2 groups, those with post‐dialysis Hgb < 13 g/dL (group 1) and those with post‐dialysis Hgb ≥13 g/dL (group 2); the differences in %ΔBW were compared between the 2 groups.RESULTSThe mean pre‐dialysis Hgb was 11.9 ± 1.4 g/dL, the mean post‐dialysis Hgb level was 12.8 ± 1.8 g/dL. The %ΔHgb was 3.9 ± 6.6 in group 1 and 10.8 ± 7.8 in group 2. The %ΔBW was 3.1 ± 1.4 in group 1 and 3.9 ± 1.7 in group 2 (p < .001 for all comparisons). We found that although both groups had a rise in Hgb level post‐dialysis, group 2 patients had a rise in %ΔHgb that was greater than the relatively small difference in %ΔBW between the 2 groups. In addition, we found only a modest correlation between %ΔBW and %ΔHgb in both groups. The r2 of 0.24 suggests that only 25% of the variability found in %ΔHgb can be related to %ΔBW.CONCLUSIONSPatients with post‐dialysis Hgb ≥13 g/dL had a greater increase in %ΔHgb that was out of proportion to %ΔBW. Factors other than %ΔBW may play a role in determining post‐dialysis Hgb.

Study of the Anti-Diuretic Hormone (ADH) on End Stage Renal Failure Disease (ESRD) Pre-Hemodialysis in Iraqi Patients

“…While reduction level of hemoglobin is related with anemia occurs in patients with renal failure because the kidneys are responsible for the secretion of the hormone erythropoietin (EPO), which is responsible for the formation of red blood cells. When kidney function is lost, thus, the number of red blood cells production decreases, causing a decrease in the level of hemoglobin responsible for anemia [24,25]. Results in Table 2, and Figure 2, observed non-significant decrease in G B when comparing with G A in sodium and non-significant increase in G B when comparing with G A in potassium, while highly significant increase in G B when comparing with G A in chloride.…”

Association between post-dialysis hemoglobin level and the survival of vascular access

“…However, other centers check CBC both pre- and post-dialysis. Some researchers consider that real Hb values are closer to the post-hemodialysis (HD) than pre-HD level, based on pre- and post-dialysis Hb findings that Hb significantly increased following an HD session, particularly in the first 24 hours, then gradually decreased over the rest of the inter-dialysis period (3-9) (Supplementary Tab. I, available online as Supplementary material at http://www.vascular-access.info), and a more recent finding that Hb at 4, 24, and 48 hours after an HD session remained elevated compared to the pre-HD Hb level, with no significant difference from the immediate post-HD Hb concentration (6).…”