Lack of Adequate Predialyis Care and Previous Hemodialysis, but Not Hemoglobin Variability, Are Independent Predictors of Anemia-Associated Mortality in Incident Brazilian Peritoneal Dialysis Patients: Results from the BRAZPD Study

Abstract

Background/Aims: The objective of this study was to analyze the prevalence of anemia and variability of hemoglobin (Hb) values in peritoneal dialysis (PD) patients, to establish its associated factors and their impact on clinical outcomes in a large cohort of patients starting PD treatment. Methods: Data were collected monthly in incident patients, who were followed until the primary endpoint (death from all causes) or until leaving the study. Results: 2,156 patients starting PD were included. The prevalence of Hb lower than 11 g/dl was 57% at baseline and decreased to 38% at the 4th month. Lack of adequate predialysis care and previous treatment with hemodialysis were the most important factors associated with anemia. Anemia was an independent predictor of mortality. There were no differences in patient survival throughout the different groups of Hb variability. Conclusion: Our data point to the need of identifying other risk factors for anemia and aggressively interfere with the modifiable ones in order to correct anemia and decrease mortality in this group of high-risk patients.

Continuous Ambulatory Peritoneal Dialysis in Limpopo Province, South Africa: Predictors of Patient and Technique Survival

“…In one large Chinese study, among independent risk factors of mortality in CAPD patients with diabetes were lower hemoglobin (HR 0.978, 95% CI 0.964 – 0.992, p = 0.003) and lower serum albumin (HR 0.924, 95% CI 0.876 – 0.976, p = 0.004) at initiation of CAPD (21). Also, the BRAZPD study, a large cohort of PD patients in Brazil, reported anemia (hemoglobin [Hb] < 11 g/dl) to be present in 57% of CAPD patients at baseline and to be an independent predictor of mortality (22). Although an attempt is often made for all CAPD patients treated at the PKDC unit in Limpopo to receive adequate anemia treatment according to guidelines, the role of nutritional status in these patients, which was not assessed in this study, could have contributed to anemia.…”

Aspectos epidemiológicos de pacientes com doença renal crônica em programa de diálise peritoneal: levantamento de 22 anos

“…Diversos estudos corroboram com esses achados (DE MORAES et al, 2014;OLIVEIRA et al, 2014;RAJAEEFARD et al, 2016;VAVRUK et al 2012, GONÇALVES et al, 2013 .…”

“…Esse dado é semelhante em vários estudos (BAE et al, 2015;GONÇALVES et al, 2013;OLIVEIRA et al, 2014;SANABRIA et al, 2015). Ao analisarmos a média Ainda Bevilacqua et al (1995) descreveu dados referentes ao tempo de acompanhamento inferior ao deste estudo como também, Oliveira et al (2016) no qual o tempo de acompanhamento foi de 1,5 anos de seguimento.…”