Effects Of Hemoglobin Levels On Cardio-cerebrovascular Events And Occlusion Of Arteriovenous Fistula In Maintenance Hemodialysis Patients

Objective:A comprehensive understanding of hemoglobin levels on the cardiovascular and cerebrovascular events and occlusion of arteriovenous fistula events in maintenance hemodialysis patients,in order to maintain a suitable hemoglobin level to improve the treatment and prognosis of MHD patients.Method:Taking the hemodialysis patients in the hemodialysis room of the Second Hospital of Jilin University as the research objects,we collected the basic information of the patients from January 2015 to September 2017 : name,sex,age,primary disease,internal fistula,complications,iron dosage,erythropoietin dosage,heparin dosage,etc.Laboratory test information : hemoglobin,hematocrit,platelet,plasma albumin,serum creatinine,serum calcium,phosphorus,activated partial thromboplastin time(APTT),parathyroid hormone,serum ferritin,transferrin saturation and other related checks.Through the statistical analysis of the above indicators,study the impact factors of hemoglobin levels and hemoglobin levels on cardiovascular and cerebrovascular events and arteriovenous fistula obstructive events to determine the appropriate hemoglobin levels in patients with MHD.Results:1.A total of 114 patients with inclusion criteria were enrolled in the survey,including 70 males(61.40%)and 44 females(38.60%)with an average age of 58.30 ± 13.37 years.The main primary disease: chronic glomerulonephritis and nephrotic syndrome in 40 cases,34 cases of diabetic nephropathy,hypertensive nephropathy in 21 cases,polycystic kidney disease in 9 cases,6 cases of chronic interstitial nephritis,the other 4 cases.Hemoglobin compliance rate is 66.67%.2.Hemoglobin was positively correlated with hematocrit,albumin,creatinine,serum phosphorus,dialysis age,and negatively correlated with sex,age,serum ferritin,erythropoietin dose,and iron dose.The difference was statistically significant(P < 0.05).3.Age and serum phosphorus were independent risk factors for cardiovascular events.Hemoglobin compliance was an independent protective factor for cardiovascular events;the incidence of cardiovascular and cerebrovascular events between different hemoglobin levels was not statistically significant(P>0.05);with hemoglobin Increase,the occurrence of arteriovenous fistula obstruction events increased,the difference between the three groups was statistically significant(P <0.05).Conclusions:1.The primary disease was more common in chronic glomerulonephritis and nephrotic syndrome,and the hemoglobin compliance rate is 66.67%.2.Hemoglobin was positively correlated with hematocrit,albumin,creatinine,serum phosphorus,dialysis age,and negatively correlated with sex,age,serum ferritin,erythropoietin dosage,and iron dosage.3.Hemoglobin compliance(Hb?110g/L)is an independent protective factor for cardiovascular events;high hemoglobin levels(Hb>125g/L)increase the incidence of arteriovenous fistula obstruction events.