The Influence Factors Of Hemoglobin Fluctuation In The Maintenance Hemodialysis Patients With Anemia

Objectives:To discussed the phenomenon of hemoglobin fluctuation and its influencing factors in maintenance hemodialysis (MHD) patients.Method:This research observed140MHD patients who had finished maintenance hemodialysis over3months in our blood purification center. We collected the information such as biochemical criterion, Drug-use and clinical states etc of the patients. We assessed the phenomenon of hemoglobin fluctuation and the factors that influence the fluctuation trend by counting statistics, at the same time, assessed the standard deviation of the average hemoglobin ratio in each case that the different drug-use, hospitalization and dialysis conditions etc after3moths by mean of single factor analysis of variance.Result:â‘ The hemoglobin fluctuation existed in82.7%of the follow-up patients in3months,30.1%of which showed complete hemoglobin fluctuation cycle.â‘¡From the analysis for the factors of rise and decline trend of hemoglobin fluctuation, the factors associated with hemoglobin fluctuation included erythropoietin (62.6%), hospitalization (13.9%), iron (10.2%), levocarnitine(5.3%) and other factors(8.0%), as pulmonary infection and hemodialysis etc.â‘¢The standard deviation of the average hemoglobin ratio in the patients who used iron or levocarnitine was greater than the patients who did not use iron or levocarnitine, and the difference had statistics significance (p<0.05); the standard deviation of the average hemoglobin ratio in the patients whose D-value of ultrafiltration volume was equal or more than2000ml was greater than the patients whose D-value of ultrafiltration volume was less than2000ml, and the difference had statistics significance (p<0.05); the standard deviation of the average hemoglobin ratio in the patients whose value of FS was between200and500ng/ml was least, and the difference had statistics significance (p<0.05); the standard deviation of the average hemoglobin ratio in the patients whose the dose of erythropoietin (EPO) was between120and150IU/kg.w was least, and the difference had statistics significance (p<0.05); the standard deviation of the average hemoglobin ratio in the patients who used high flux dialyser was greater than the patients who used low flux dialyser, and the difference had statistics significance (p<0.05).Conclusion:The hemoglobin fluctuation was found in more than80%MHD patients, and it had cyclicity; factors that contained EPO, iron and iron storage state, levocarnitine, hospitalization, infection, hemodialysis(dialysis adequacy, kind of dialyser, D-value of ultrafiltration volume and so on) could all lead to hemoglobin fluctuation, the factor for EPO was very important factors among them; using iron or levocarnitine could increase the range of fluctuation, the dose of EPO was big or small or the iron store insufficient or excessive all could increase the range, and using high flux dialyser could also increase the range. The thesis comprises10figures,6tables and36references.