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Variability in Hemoglobin Levels and the Factors Associated with Mortality in Hemodialysis Patients: A 78-Month Follow-Up Study
Some studies have described that when the hemoglobin levels of chronic kidney disease (CKD) patients change, especially in those taking erythropoiesis-stimulating agents (ESA), they are associated with unfavorable outcomes such as increased morbidity and mortality, mainly due to cardiovascular event...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7908351/ https://www.ncbi.nlm.nih.gov/pubmed/33530448 http://dx.doi.org/10.3390/ijerph18031078 |
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author | Salgado Filho, Natalino Lages, Joyce Santos Brito, Dyego José de Araújo Santos, Elton John Freitas dos Santos, Alcione Miranda de Souza, Francival Leite Mendes, Vinícius Giuliano Gonçalves Silva, Giselle Andrade dos Santos Carneiro, Erika Cristina Ribeiro de Lima Muniz, Monique Pereira Rêgo Silva, Gyl Eanes Barros Sesso, Ricardo de Castro Cintra |
author_facet | Salgado Filho, Natalino Lages, Joyce Santos Brito, Dyego José de Araújo Santos, Elton John Freitas dos Santos, Alcione Miranda de Souza, Francival Leite Mendes, Vinícius Giuliano Gonçalves Silva, Giselle Andrade dos Santos Carneiro, Erika Cristina Ribeiro de Lima Muniz, Monique Pereira Rêgo Silva, Gyl Eanes Barros Sesso, Ricardo de Castro Cintra |
author_sort | Salgado Filho, Natalino |
collection | PubMed |
description | Some studies have described that when the hemoglobin levels of chronic kidney disease (CKD) patients change, especially in those taking erythropoiesis-stimulating agents (ESA), they are associated with unfavorable outcomes such as increased morbidity and mortality, mainly due to cardiovascular events. This prospective cohort study included patients with end-stage renal disease currently undergoing hemodialysis. The initial 6-month clinical evaluation provided data of the variability in hemoglobin, associated blood parameters, and the use of erythropoietin. Subsequently, the patients were followed up for 78 months to evaluate mortality-associated factors. In total, 133 patients completed the 6-month follow-up with a mean age of 47.1 (±13.2) years. The majority were women (51.9%). Six-month hemoglobin levels were as follows: always low (18.0%), intermediate/target (1.5%), always high (0.8%), low-amplitude fluctuation/Hb low (n = 37; 27.8%), low-amplitude fluctuation/Hb high (13.53%), and high-amplitude fluctuation (38.6%), among end-stage renal disease patients. At the end of 78 months, 50 (37.6%) patients died; 70% of deaths were attributed to cardiovascular etiologies. A high variability was observed in hemoglobin levels, which was not associated with mortality. Among all the variables evaluated, age, erythropoietin dose, and transferrin saturation were associated with a higher mortality. Thus, this study suggests that greater attention to erythropoietin doses and transferrin saturation levels may improve the survival of dialysis patients. |
format | Online Article Text |
id | pubmed-7908351 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-79083512021-02-27 Variability in Hemoglobin Levels and the Factors Associated with Mortality in Hemodialysis Patients: A 78-Month Follow-Up Study Salgado Filho, Natalino Lages, Joyce Santos Brito, Dyego José de Araújo Santos, Elton John Freitas dos Santos, Alcione Miranda de Souza, Francival Leite Mendes, Vinícius Giuliano Gonçalves Silva, Giselle Andrade dos Santos Carneiro, Erika Cristina Ribeiro de Lima Muniz, Monique Pereira Rêgo Silva, Gyl Eanes Barros Sesso, Ricardo de Castro Cintra Int J Environ Res Public Health Article Some studies have described that when the hemoglobin levels of chronic kidney disease (CKD) patients change, especially in those taking erythropoiesis-stimulating agents (ESA), they are associated with unfavorable outcomes such as increased morbidity and mortality, mainly due to cardiovascular events. This prospective cohort study included patients with end-stage renal disease currently undergoing hemodialysis. The initial 6-month clinical evaluation provided data of the variability in hemoglobin, associated blood parameters, and the use of erythropoietin. Subsequently, the patients were followed up for 78 months to evaluate mortality-associated factors. In total, 133 patients completed the 6-month follow-up with a mean age of 47.1 (±13.2) years. The majority were women (51.9%). Six-month hemoglobin levels were as follows: always low (18.0%), intermediate/target (1.5%), always high (0.8%), low-amplitude fluctuation/Hb low (n = 37; 27.8%), low-amplitude fluctuation/Hb high (13.53%), and high-amplitude fluctuation (38.6%), among end-stage renal disease patients. At the end of 78 months, 50 (37.6%) patients died; 70% of deaths were attributed to cardiovascular etiologies. A high variability was observed in hemoglobin levels, which was not associated with mortality. Among all the variables evaluated, age, erythropoietin dose, and transferrin saturation were associated with a higher mortality. Thus, this study suggests that greater attention to erythropoietin doses and transferrin saturation levels may improve the survival of dialysis patients. MDPI 2021-01-26 2021-02 /pmc/articles/PMC7908351/ /pubmed/33530448 http://dx.doi.org/10.3390/ijerph18031078 Text en © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Salgado Filho, Natalino Lages, Joyce Santos Brito, Dyego José de Araújo Santos, Elton John Freitas dos Santos, Alcione Miranda de Souza, Francival Leite Mendes, Vinícius Giuliano Gonçalves Silva, Giselle Andrade dos Santos Carneiro, Erika Cristina Ribeiro de Lima Muniz, Monique Pereira Rêgo Silva, Gyl Eanes Barros Sesso, Ricardo de Castro Cintra Variability in Hemoglobin Levels and the Factors Associated with Mortality in Hemodialysis Patients: A 78-Month Follow-Up Study |
title | Variability in Hemoglobin Levels and the Factors Associated with Mortality in Hemodialysis Patients: A 78-Month Follow-Up Study |
title_full | Variability in Hemoglobin Levels and the Factors Associated with Mortality in Hemodialysis Patients: A 78-Month Follow-Up Study |
title_fullStr | Variability in Hemoglobin Levels and the Factors Associated with Mortality in Hemodialysis Patients: A 78-Month Follow-Up Study |
title_full_unstemmed | Variability in Hemoglobin Levels and the Factors Associated with Mortality in Hemodialysis Patients: A 78-Month Follow-Up Study |
title_short | Variability in Hemoglobin Levels and the Factors Associated with Mortality in Hemodialysis Patients: A 78-Month Follow-Up Study |
title_sort | variability in hemoglobin levels and the factors associated with mortality in hemodialysis patients: a 78-month follow-up study |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7908351/ https://www.ncbi.nlm.nih.gov/pubmed/33530448 http://dx.doi.org/10.3390/ijerph18031078 |
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