Anemia Condition And Its Relationship With Dialysis Age In Patients With Different Dialysis Methods

Objective: To compare the anemia condition and the influence of dialysis age on anemia between patients in maintenance peritoneal dialysis(MPD)and maintenance hemodialysis(MHD).To explore the factors affecting the target level of hemoglobin(Hb)in the two groups.Methods: A retrospective study is conducted to collect the patients who receive maintenance dialysis treatment regularly in the Department of Nephrology of the Second Affiliated Hospital of Hainan Medical University from January 2020 to November 2020 according to the inclusion and exclusion criteria,including 187 patients in the MPD group and 184 patients in the MHD group.The general information(age,gender,primary disease,dialysis age,BMI),blood routine results,iron metabolism indexes,hypersensitive C-reactive protein,serum calcium,serum phosphorus,serum creatinine,blood parathyroid hormone,blood lipid and other indexes of the patients are collected.Comparing the incidence of anemia and Hb compliance rate of patients with two kinds of dialysis prescriptions.To compare the difference of hemoglobin in patients with two dialysis methods at different dialysis ages.Apply binary Logistic regression to analyze the related factors affecting the target value of Hb.Results:(1).The Hb level in MHD group is higher significantly than MPD group,(P <0.05);The incidence of anemia in MPD group is 87.70% and that is 84.78% in MHD group,the difference is unconspicuous(P > 0.05).The Hb compliance rate of MPD group is 21.4% which is 34.8% in MHD group,the difference is significant(P < 0.05).(2).In the MPD group,there is a negative correlation between Hb and dialysis age(r=-0.200,P=0.006),but no correlation in the MHD group(r=0.126,P=0.089).In dialysis age ≤1 year stage,there is no significant difference in Hb level between MPD group and MHD group(P > 0.05).In other dialysis age stages,the Hb level in MHD group is higher than MPD group,and the difference is significant(P < 0.05).(3).The level of hypersensitive C-reactive protein in MPD group is higher than MHD group.The propotion of microinflammation is 59.4% in MPD patients and 46.2% in MHD patients,the difference is significant(P < 0.05).(4).Hypoproteinemia is a risk factor for hemoglobin compliance in both MPD group and MHD group while HDL is a protective factor.Hypocalcemia is a risk factor for hemoglobin compliance in the MPD group;and transferrin saturation is a protective factor for hemoglobin compliance in the MHD group.Conclusions: Anemia is common among patients in this dialysis center,and the degree of anemia in MHD patients is milder than that in MPD patients.The anemia status of MHD patients is better than MPD patients with the increase of dialysis age after more than 1 year.The degree and incidence of microinflammation in MPD patients are higher than MHD patients.Improving the levels of serum albumin and HDL is beneficial to reaching hemoglobin target in maintenance dialysis patients.