Department of Nephrology, The Affiliated Hospital of Qingdao University, Qingdao, China.
Department of Nutrition, The Affiliated Hospital of Qingdao University, Qingdao, China.
Ren Fail. 2024 Dec;46(1):2296609. doi: 10.1080/0886022X.2023.2296609. Epub 2024 Jan 4.
This study aimed to investigate the correlation between ultrafiltration rate (UFR) and hemoglobin levels and erythropoietin (EPO) response in patients receiving maintenance hemodialysis (MHD). 225 MHD patients were divided into three groups according to the UFR: < 10 ml/h/kg, 10-13 ml/h/kg, and >13 ml/h/kg. Clinical parameters and prognosis were compared among the groups. Multiple linear correlation and regression analyses were conducted. SPSS 26.0 (IBM, Chicago, IL, USA) was used to analyze all statistics. The UFR < 10 ml/h/kg group was older than the other groups ( < 0.05). The UFR > 13 ml/h/kg group had the highest SpKt/V ( < 0.05), monthly EPO dose/weight ( < 0.001), and EPO resistance index ( < 0.001), as well as the lowest dry weight ( < 0.001), BMI ( < 0.001), hemoglobin ( < 0.001), hematocrit ( < 0.05), and red blood cell count ( < 0.05). Multiple linear regression analysis showed that sex, dry weight, UFR, calcium, phosphorus, albumin, and C-reactive protein levels were associated with hemoglobin levels. Multivariate logistic regression analysis revealed that a higher UFR was associated with lower hemoglobin levels, while male sex and higher levels of calcium and albumin were associated with higher hemoglobin levels. High UFR is associated with more severe anemia and EPO resistance in MHD. This study provides new insights into anemia management in patients undergoing hemodialysis.
本研究旨在探讨维持性血液透析(MHD)患者超滤率(UFR)与血红蛋白水平和红细胞生成素(EPO)反应的相关性。将 225 例 MHD 患者根据 UFR 分为三组:<10ml/h/kg、10-13ml/h/kg 和>13ml/h/kg。比较各组间的临床参数和预后。进行多元线性相关和回归分析。使用 SPSS 26.0(IBM,芝加哥,IL,美国)分析所有统计数据。UFR<10ml/h/kg 组比其他组年龄更大(<0.05)。UFR>13ml/h/kg 组的 SpKt/V 最高(<0.05)、每月 EPO 剂量/体重最高(<0.001)、EPO 抵抗指数最高(<0.001),以及干体重最低(<0.001)、BMI 最低(<0.001)、血红蛋白最低(<0.001)、血细胞比容最低(<0.05)和红细胞计数最低(<0.05)。多元线性回归分析表明,性别、干体重、UFR、钙、磷、白蛋白和 C 反应蛋白水平与血红蛋白水平相关。多变量逻辑回归分析显示,较高的 UFR 与较低的血红蛋白水平相关,而男性和较高的钙和白蛋白水平与较高的血红蛋白水平相关。高 UFR 与 MHD 患者更严重的贫血和 EPO 抵抗有关。本研究为血液透析患者的贫血管理提供了新的见解。