Cognition And Influencing Factors Of Anemia In Maintenance Hemodialysis Patients

Objectives:To study the influencing factors of anemia in maintenance hemodialysis patients and to investigate cognition of patients with renal anemia.Methods:A total of 100 renal anemia patients were enrolled according to the inclusion and exclusion criteriain in patients with MHD at the Second Affiliated Hospital of Nanchang University from July 1st,2016 to September 30 st,2016.An interview was conducted on each of the included patients.To understand the knowledge of renal anemia in MHD patients,the prevalence of anemia and the treatment of compliance with hemoglobin levels reaching the guideline target hemodlobin(Hb)≥110g/l and the associated factors of anemia were analyzed.Statistical methods: all data were analyzed by SPSS22.0 software.The Hb target is beyond 110g/l,sub-Hb compliance group and non-compliance group.And the count data between the groups using the chi-square test or Fisher exact test method;Hb compliance group and non-compliance group comparison using t test or rank test;The correlation between the indexes and the Hb level was analyzed by Pearson correlation analysis,and the independent influencing factors of Hb noncompliance were analyzed by Logistic regression.Results:1.A total of 100 patients,the prevalence of anemia was 92%,the average Hb was 97.63±19.28g/l;Hb compliance rate was 25%,hematocrit(Hct)compliance rate was 35%,the average Hct was(30.81±5.37)%;ferritin compliance rate was 76%,the average was 478.19(219.06,679.91)ug/l;Transferrin saturation(TSAT)compliance rate was 65%,the average was(38.91±22.25)%.There were 82%,56%and37% of patients treated with iron,folic acid and VitB12,respectively.2.Patients with different age groups had a statistically significant difference in when patients begin to use iron、monitoring duration of Hb 、serum ferritin and parathyroid hormone(PTH)(P values were 0.015 、 0.035 、 0.009 and 0.047,respectively).There are statistically significant differences in whether or not the hemoglobin target level is known to correct the anemia for the use of iron,iron metabolism and PTH monitoring frequency for patients with different education(P = 0.031,0.036,0.021 and 0.026,respectively).3.Compared with the hemoglobin noncompliant group,serum albumin level and serum iron level were higher,the difference was statistically significant(P = 0.033,0.006),the usage folic acid and vitamin B12 were decreased(P <0.01).4.The hemoglobin level in MHD patients had positive linear correlation with serum iron level(r = 0.366,P<0.001),and had negative linear correlation with the dose of EPO(r =-0.214,P = 0.037).5.Multivariate logistic regression analysis showed that dialysis frequencies(β = 1.452,P = 0.029,OR = 4.72 95% CI 1.159 ~ 15.753),serum iron(β = 0.14,P = 0.03,OR = 1.151,95% CI 1.014 ~ 1.307)were collected to anemia.Conclusions:Although the treatment of renal anemia has been taken attention seriously,the compliance is still low.It associate with order age,low level of education,lacking of renal anemia knowledge,delayed disease monitoring,poor treatment compliance.The iron deficiency and low dialysis dose are the independent factors affecting the anemia compliance.