Department of Nephrology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, 160 Pu Jian Road, 200127, Shanghai, China.
Int Urol Nephrol. 2018 Jan;50(1):167-171. doi: 10.1007/s11255-017-1722-8. Epub 2017 Nov 1.
To investigate the effect of hemoglobin fluctuations on cardiovascular prognosis of patients on peritoneal dialysis (PD).
Retrospective descriptive study, with sample composed of 333 patients treated with PD at the Renal Unit. Two indicators were adopted to indicate hemoglobin fluctuations of PD patients: absolute value of hemoglobin variability (HV) and HV trend. Moreover, the new cardiovascular events and recurrent rate of cardiovascular events within 3 months after PD were recorded and were compared in groups of PD patients classified by hemoglobin fluctuation indicators.
Patients whose HV value is less than 10 g/l have an increased risk of new cardiovascular events than patients with HV value > 10 g/l (27.2 vs. 12.2%, p < 0.05) during 3 months after PD. Patients who kept high hemoglobin values (≥ 110 g/l) 3 months after PD are prone to develop recurrent cardiovascular events than patients with relatively low hemoglobin values (< 110 g/l; p < 0.05).
Hemoglobin fluctuations were associated with the cardiovascular prognosis in patients on PD. A limitation of our study is its retrospective design. However, the results in this research indicated anemia in PD patients without cardiovascular events history should be timely treated. Instead, hemoglobin should be kept within a relatively low level in patients with history of cardiovascular events. Additional clinical researches are needed to verify and improve our findings.
探讨血红蛋白波动对腹膜透析（PD）患者心血管预后的影响。
回顾性描述性研究，样本由在肾脏科接受 PD 治疗的 333 名患者组成。采用血红蛋白波动的绝对值（HV）和 HV 趋势两个指标来表示 PD 患者的血红蛋白波动情况。此外，记录 PD 患者在 PD 后 3 个月内的新心血管事件和心血管事件复发率，并根据血红蛋白波动指标对患者进行分组比较。
PD 后 3 个月，HV 值<10 g/l 的患者发生新心血管事件的风险高于 HV 值>10 g/l 的患者（27.2%比 12.2%，p<0.05）。PD 后 3 个月保持较高血红蛋白值（≥110 g/l）的患者比血红蛋白值相对较低（<110 g/l）的患者更容易发生复发性心血管事件（p<0.05）。
血红蛋白波动与 PD 患者的心血管预后有关。本研究的局限性在于其回顾性设计。然而，这项研究的结果表明，没有心血管事件史的 PD 患者的贫血应及时治疗。相反，有心血管事件史的患者应将血红蛋白保持在相对较低的水平。需要进一步的临床研究来验证和改进我们的发现。
