Di Iorio B, Cirillo M, Bellizzi V, Stellato D, De Santo N G
Department of Nephrology, Second University of Naples, Naples - Italy.
Int J Artif Organs. 2007 Apr;30(4):325-33.
This study investigated prevalence and correlates of anemia and uncontrolled anemia in chronic hemodialysis patients.
A cross-sectional analysis was performed on registry data for 2,746 chronic (>6 months) hemodialysis patients aged 25-84. Data collection included years of dialysis, hours of dialysis/wk, disease causing hemodialysis, body mass index (BMI), erythropoietin (EPO) treatment, hemoglobin, markers of viral hepatitis, serum albumin, calcium, and phosphorus.
Prevalence was 88.7% for anemia (hemoglobin <11 g/100 mL and EPO treatment at any Hb level), 39.4% for uncontrolled anemia (hemoglobin<11 g/100 mL). Gender, years of dialysis, hereditary cystic kidney disease (HCKD), and low BMI (<24 kg/m2) were independent correlates of anemia (P<0.001). Gender, HCKD, low BMI, serum albumin and calcium were independent correlates of uncontrolled anemia (P<0.05). An interaction was found between age (not correlated with anemia and uncontrolled anemia) and the association of gender with uncontrolled anemia (P<0.05). EPO doses were higher in patients with high prevalence of uncontrolled anemia than in patients with low prevalence (i.e., women vs men, other diseases vs HCKD, low vs not-low BMI, P<0.01). Gender, years of dialysis, HCKD, BMI, serum albumin, and calcium were independent correlates of the hemoglobin/EPO dose ratio in patients on EPO treatment (P<0.05).
Anemia and uncontrolled anemia are more frequent in hemodialysis patients with shortterm dialysis, diseases other than HCKD, low BMI, and female gender. Gender effect was lower in elderly patients. Uncontrolled anemia was also associated with low serum albumin and calcium, suggesting that these parameters are indices of EPO resistance.
本研究调查了慢性血液透析患者贫血及未控制贫血的患病率及其相关因素。
对2746例年龄在25 - 84岁的慢性（>6个月）血液透析患者的登记数据进行横断面分析。数据收集包括透析年限、每周透析时长、导致血液透析的疾病、体重指数（BMI）、促红细胞生成素（EPO）治疗情况、血红蛋白、病毒性肝炎标志物、血清白蛋白、钙和磷。
贫血（血红蛋白<11 g/100 mL且在任何血红蛋白水平接受EPO治疗）的患病率为88.7%，未控制贫血（血红蛋白<11 g/100 mL）的患病率为39.4%。性别、透析年限、遗传性囊性肾病（HCKD）和低BMI（<24 kg/m²）是贫血的独立相关因素（P<0.001）。性别、HCKD、低BMI、血清白蛋白和钙是未控制贫血的独立相关因素（P<0.05）。发现年龄（与贫血和未控制贫血无关）与性别和未控制贫血的关联之间存在交互作用（P<0.05）。未控制贫血患病率高的患者比患病率低的患者EPO剂量更高（即女性与男性、其他疾病与HCKD、低BMI与非低BMI，P<0.01）。性别、透析年限、HCKD、BMI、血清白蛋白和钙是接受EPO治疗患者血红蛋白/EPO剂量比的独立相关因素（P<0.05）。
短期透析、非HCKD疾病、低BMI和女性的血液透析患者中贫血和未控制贫血更为常见。老年患者的性别影响较低。未控制贫血还与低血清白蛋白和钙相关，提示这些参数是EPO抵抗的指标。
