[an error occurred while processing this directive]

Regional multicenter investigation of anemia and iron status in maintenance hemodialysis patients

  • XING Jie ,
  • WANG Gui-Hua ,
  • ZHANG Liu-Ping ,
  • XIE Qing-Lei ,
  • LU Wen ,
  • CHEN Feng-Ling ,
  • FANG Ya-Xiang ,
  • HE Wei-Ming ,
  • DING Hong ,
  • WANG De-Guang ,
  • PAN You-Wen ,
  • JIN Wei-Min ,
  • LI Yu-Dan ,
  • LIU Jian-Jing ,
  • WEI Shan-Zhai ,
  • FANG Li-Ming ,
  • CHEN Xiao-Lan ,
  • ZHANG Xiao-Liang
Expand
  • Department of Nephrology, ZhongDa Hospital, School of Medicine, Southeast University, Nanjing 210009, China; 2Department of Nephrology, The First Affiliated Hospital of Soochow University, Suzhou 215001, China; 3Department of Nephrology, The Fourth People 's Hospital of Taizhou, Taizhou 225444, China; 4Department of Nephrology, Jiangsu Provincial Hospital of Traditional Chinese Medicine, Nanjing 211899, China; 5Department of Nephrology, Yangzhong People' s Hospital, Zhenjiang 212299, China; 6Department of Nephrology, The Second Hospital of Anhui Medical University, Hefei 230601, China; 7Department of Nephrology, Lai'an County People 's Hospital, Chuzhou 239299, China; 8Department of Nephrology, Suzhou Hospital of Traditional Chinese Medicine, Suzhou 215499, China; 9Department of Nephrology, Jiangxi Provincial Hospital of Integrated Traditional Chinese and Western Medicine, Nanchang 331799, China; 10Department of Nephrology, Nanjing Lishui District Hospital of Traditional Chinese Medicine, Nanjing 211299, China; 11Department of Nephrology, Shuyang County Hospital of Traditional Chinese Medicine, Suqian 223699, China; 12Department of Nephrology, Jiangsu Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing 210028, China; 13Department of Nephrology, Affiliated Hospital of Nantong University, Nantong 226007, China

Received date: 2022-10-24

  Revised date: 2022-11-07

  Online published: 2023-01-12

Abstract

Objective This study intended to conduct a cross-sectional survey of anemia and iron status distribution characteristics and drug use in regional maintenance hemodialysis patients to clarify the relationship between relevant indicators and provide data support for the development of optimal anemia management strategies. Methods Twelve blood purification centers in three provinces including Jiangsu Province, Anhui Province and Jiangxi Province were selected. Maintenance hemodialysis patients from September 2021 to December 2021 were included. General demographic data and laboratory parameters before dialysis were collected. Relevant analysis methods were used to describe hemoglobin (Hb) reaching standards, anemia and iron status distribution characteristics of multicenter maintenance hemodialysis patients, and to explore the related factors affecting the control rate of Hb. Results A total of 1814 patients who met the criteria were included in this study, including 1116 males and 698 females, with a mean age of 58.0±14.0 years. The overall control rate of Hb was 48.5%, and the Hb distribution and control rate were significantly different among the sub-centers (P < 0.001). The vast majority of patients had serum ferritin (SF) < 200 μg/L and 2% had SF more than 1000 μg/L. Transferrin Saturation (TSAT) ranged from 20-49% in 64.8% of patients. For every 1% change in TSAT, the OR of Hb reaching target was 1.029 (P=0.023, 95% CI=1.004-1.055). Conclusion The overall control rate of Hb of sample units was not satisfactory, most patients had moderate or slight iron reserve, and very few patients had iron overload. There were significant differences in Hb and iron status distribution characteristics among sub-centers. TSAT was an independent protective factor for good control rate of Hb.

Cite this article

XING Jie , WANG Gui-Hua , ZHANG Liu-Ping , XIE Qing-Lei , LU Wen , CHEN Feng-Ling , FANG Ya-Xiang , HE Wei-Ming , DING Hong , WANG De-Guang , PAN You-Wen , JIN Wei-Min , LI Yu-Dan , LIU Jian-Jing , WEI Shan-Zhai , FANG Li-Ming , CHEN Xiao-Lan , ZHANG Xiao-Liang . Regional multicenter investigation of anemia and iron status in maintenance hemodialysis patients[J]. Chinese Journal of Blood Purification, 2023 , 22(1) : 1 -6 . DOI: 10.3969/j.issn.1671-4091.2023.01.001

References

[1]van Haalen H, Jackson J, Spinowitz B, et al.Impact of chronic kidney disease and anemia on health-related quality of life and work productivity: analysis of multinational real-world data[J].BMC Nephrol, 2020, 21(1):88-
[2]Awan A A, Walther C P, Richardson P A, et al.Prevalence,correlates and outcomes of absolute and functional iron deficiency anemia in nondialysis-dependent chronic kidney disease[J].Nephrol Dial Transplant, 2021, 36(1):129-136
[3]Gunnar T, Ufe H J, Heleen V H, et al.Anemia and clinical outcomes in patients with non-dialysis dependent or dialysis dependent severe chronic kidney disease: a Danish population-based study[J].Journal of Nephrology, 2020, 33(1):147-156
[4]Yamamoto H, Tsubakihara Y.Limiting iron supplementation for anemia in dialysis patients--the Basis for Japan′s conservative guidelines[J].Semin Dial, 2011, 24(3):269-271
[5] Kidney Disease:Improving Global Outcomes (KDIGO) Anemia Work Group..KDIGO clinical practice guideline for anemia in CKD [J].[J].Kidney Int Suppl , 2011, 4(2):288-316
[6]中华医学会血液学分会,中国医师协会血液科医师分会.铁过载诊断与治疗的中国专家共识[J].中华血液学杂志, 2011, 32(8):572-574
[7]Zhao X, Niu Q, Gan L, et al.Baseline data report of the China Dialysis Outcomes and Practice Patterns Study (DOPPS)[J].Sci Rep, 2021, 11(1):873-
[8] 陈晓农, 李萍, 陈孜瑾, 等.上海瑞金医院维持性血液透析患者贫血达标率和治疗情况的5年调查: 第九届中国血液净化论坛暨2017年中国医院协会血液净化中心管理分会年会, 北京, 2017[C].
[9]叶蕾, 张桂霞, 黄扬扬, 等.安徽省维持性血液透析患者贫血患病率及血红蛋白达标率的流行病学调查[J].中华肾脏病杂志, 2016, 32(4):264-270
[10] Pisoni RL,Bragg-Gresham JL,Young EW,et a1.Anemia management and outcomes from 12 countries in the Dialysis Outcomes and Practice Patterns Study (DOPPS) [J]. Am J Kidney Dis, 2004, 44: 94-111.
[11]Kalantar-Zadeh K, Regidor DL, McAllister CJ, et al.Time-dependent associations between iron and ortality in hemodialysis patients[J].J Am Soc Nephrol, 2005, 16(10):3070-3080
[12]Brookhart MA, Freburger JK, Ellis AR, et al.Infection risk with bolus versus maintenance iron supplementation in hemodialysis patients[J].J Am Soc Nephrol, 2013, 24(7):1151-1158
[13]Kshirsagar AV, Freburger JK, Ellis AR, et al.Intravenous iron supplementation practices and short-term risk of cardiovascular events in hemodialysis patients[J].PLoS One, 2013, 8(11):e78930-
[14]Kshirsagar AV, Freburger JK, Ellis AR, et al.The comparative short-term effectiveness of iron dosing and formulations in US hemodialysis patients[J].Am J Med, 2013, 126(6):541-
[15] Macdougall IC, White C, Anker SD, et al.Intravenous iron in patients undergoing maintenance hemodialysis[J]. N Engl J Med, 2019. 380: 447-458.
[16]Billesbolle C B, Azumaya C M, Kretsch R C, et al.Structure of hepcidin-bound ferroportin reveals iron homeostatic mechanisms[J].Nature, 2020, 586(7831):807-811
[17]Honda H, Kobayashi Y, Onuma S, et al.Associations among Erythroferrone and Biomarkers of Erythropoiesis and Iron Metabolism,and Treatment with Long-Term Erythropoiesis-Stimulating Agents in Patients on Hemodialysis[J].PLoS One, 2016, 11(3):e151601-
[18] Kazuya T, Naohisa T, Chikako T, et al.Regulation of Hepcidin-25 by Short- and Long-Acting rhEPO May Be Dependent on Ferritin and Predict the Response to rhEPO in Hemodialysis Patients.[J] .Nephron Extra, 2014, 4: 55-63.
[19]Chen N, Hao C, Liu BC, et al.Roxadustat treatment for anemia in patients undergoing long-term dialysis[J].N Engl J Med, 2019, 381(11):1011-1022
[20]Chen N, Hao C, Peng X, et al.Roxadustat for anemia in patients with kidney disease not receiving dialysis[J].N Engl J Med, 2019, 381(11):1001-1010
[21] Nangaku M, Hamano T, Akizawa T, et al.Daprodustat Compared with Epoetin Beta Pegol for Anemia in Japanese Patients Not on Dialysis: A 52-Week Randomized Open-Label Phase 3 Trial. American Journal of Nephrology, 2021: p. 1-10.
Outlines

/

[an error occurred while processing this directive]