Study On Anemia And Related Factors In Uremia Patients With Different Dialysis Methods

Objective: To compare the difference of anemia degree between two groups of peritoneal dialysis(PD)and hemodialysis(HD),to discuss the influence of different dialysis methods for anemia and iron metabolism,and the causes of anemia in two groups of patients with uremia and related factors.Methods:(1)To collect 115 cases of uremia hospitalized in the Department of Nephrology from December 2015 to June 2017 in Tongling municipal hospital,of which 55 were in group PD and 60 in group HD.All patients with dialysis for at least 2 year,taking fasting venous blood of patients in the early morning to measure two groups of patients: red blood cell count(RBC),hemoglobin(HB),reticulocyte(RET),serum albumin(ALB),C reactive protein(CRP),parathyroid hormone(PTH),blood urea nitrogen(BUN),serum creatinine(CR)and iron metabolism indexes: serum iron(SI)and serum ferritin(SF),transferrin(TRF),transferrin saturation(TSAT%).(2)To observe the anemia and iron metabolism in the two groups and their related factors.(3)the related factors of anemia were analyzed by Pearson correlation analysis and multiple linear stepwise regression.(4)SPSS 22 software was used for statistical treatment,and P < 0.05 was statistically significant.Results:(1)Comparison of general information between PD group and HD group : the differences of two groups in gender,age,age of dialysis had no statistical significance(P>0.05);hemoglobin and red blood cells in PD group was higher than that of HD group(P < 0.05),the difference was statistically significant;The reticulocyte in PD group was lower than that of HD group(P < 0.05),the difference was statistically significant.(2)Comparison of blood biochemical indexes between PD group and HD group:C reactive protein in PD group was significantly lower than HD group(P < 0.01),the difference was statistically significant;serum albumin in PD group was significantly lower than that of HD group(P < 0.01),the difference was statistically significant;urea nitrogen and serum creatinine in PD group were significantly higher than that of HD group(P<0.01),the difference was statistically significant.There was no statistically significant in the two groups of parathyroid hormone,serum iron,ferritin,transferrin and transferrin saturation(P>0.05).(3)Pearson correlation analysis of HB and various indexes in PD group:PD group of patients with HB levels and ALB,SI,SF,TF,PTH,TSAT and CRP index for Pearson correlation analysis,results showed that: the level of HB was positively related to ALB(r=0.974,P<0.001),SI(r=0.960,P<0.001),SF(r=0.778,P<0.001),TF(r=0.986,P<0.001),negative related to PTH(r=-0.944,P<0.001).There was no correlation between TSAT and CRP.Multiple stepwise regression analysis showed that SI(beta =1.901,P<0.001),ALB(beta =0.932,P<0.001)and PTH(beta =-0.008,P=0.031)were significant factors related to HB.(4)Pearson correlation analysis of HB and various indexes in HD group:The HB level and ALB,TRF,TSAT,CRP,SI,SF and PTH index and so on were for Pearson correlation analysis in patients of the HD group,of which results showed that: the level of HB and SI(r=0.968,P<0.001),SF(r=0.868,P<0.001)were positively related.They were negative correlation with PTH(r=-0.860,P<0.001),CRP(r=-0.624,P<0.001),and there no correlation with ALB,TRF and TSAT.Multiple stepwise regression analysis showed that SI(beta =4.036,P<0.001)and CRP(beta =-0.116,P=0.003)were the significant factors related to HB.(5)Iron metabolism index analysis of patients with different degree of anemia :Comparison of patients with mild anemia group and normal group,patients with elevated level of SI,SF and TSAT were decreased(P < 0.01).The difference was statistically significant.The level of TRF was elevated(P > 0.05),of them the difference was not statistically significant;Compared with moderate anemia group and normal group,SI,SF and TSAT level in patients was decreased(all P < 0.01).The difference of them was statistically significant and the level of TRF was elevated(P > 0.05),while the difference was not statistically significant;Normal group compared with the severe anemia group whose SI,SF and TSAT levels in patients was decreased(P < 0.01),the difference of them was significant statistical significance.The TRF level of them was elevated(P < 0.01),the difference was statistically significant.Conclusions:(1)The level of HB in patients with PD was higher than that in HD,and the degree of anemia was lower than that in HD.(2)Microinflammatory state and malnutrition existed in two groups of dialysis patients.The microinflammatory state of PD group was lighter than that of HD group,while the degree of malnutrition was heavier than that of HD group.(3)The level of HB in patients with PD was positively correlated with ALB,SI,SF,TF and negatively correlated with PTH.SI,ALB,PTH are significant related factors of HB.(4)HB levels in HD patients were positively correlated with SI and SF,but negatively correlated with PTH and CRP.SI,CRP is a significant correlation with HB.(5)The index of iron metabolism was closely related to anemia.The levels of SI,SF and TSAT were positively correlated with the level of HB,but the level of TRF was negatively correlated with the level of HB.