Division of Kidney and Dialysis, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.
Clin Exp Nephrol. 2012 Jun;16(3):448-55. doi: 10.1007/s10157-011-0584-0. Epub 2012 Jan 24.
Hemoglobin (Hb) cycling in patients with renal anemia might be associated with a higher mortality rate. We investigated the association of factors relating serum ferritin and dose of erythropoiesis-stimulating agents (ESAs) with Hb levels.
We measured Hb and ferritin levels every month in 266 hemodialysis (HD) patients for 12 months.
The standard deviation (SD) and residual SD (RSD) (liner regression of Hb or ferritin SD values) values of Hb were significantly correlated with ferritin SD or RSD values, respectively. The percentage achievement of target Hb in the target-ferritin group was significantly higher than in the high-amplitude fluctuation ferritin group. Ferritin SD and RSD values in patients with oral or no iron supplementation were significantly lower than those who received intravenous iron.
Iron storage varies over a relatively wide range in HD patients, and this variation is closely associated with Hb cycling. The stability of iron storage and ESA dosage is important for maintaining stable Hb levels.
肾衰竭贫血患者的血红蛋白（Hb）循环可能与更高的死亡率相关。我们研究了与血清铁蛋白和促红细胞生成素刺激剂（ESA）剂量相关的因素与 Hb 水平的关系。
我们在 12 个月的时间里，每个月测量 266 名血液透析（HD）患者的 Hb 和铁蛋白水平。
Hb 的标准差（SD）和残余 SD（Hb SD 值的线性回归）与铁蛋白 SD 或 RSD 值分别显著相关。靶铁蛋白组的目标 Hb 达标率明显高于高幅度波动铁蛋白组。口服或无铁补充的患者的铁蛋白 SD 和 RSD 值明显低于接受静脉铁的患者。
HD 患者的铁储存范围相对较宽，这种变化与 Hb 循环密切相关。铁储存和 ESA 剂量的稳定性对于维持稳定的 Hb 水平很重要。
