Difference between true functional haemoglobin and pre-dialysis haemoglobin is associated with plasma volume variation: a multicentre study
| Autor: | Esteban Siga, Vito Mesina, Hugo de Palma, Miguel Fernandez, Mario Jorge Galarza, Raul Coste |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Adult
Male medicine.medical_specialty Urology Pilot Projects Weight Gain Plasma volume Gastroenterology Hemoglobins Predictive Value of Tests Renal Dialysis Internal medicine Intravascular volume status medicine Humans Plasma Volume Aged business.industry Pre-dialysis Odds ratio Middle Aged Confidence interval Surgery Quartile Nephrology Predictive value of tests Hematinics Female Kidney Diseases medicine.symptom business Weight gain |
| Zdroj: | International Urology and Nephrology. 46:2379-2384 |
| ISSN: | 1573-2584 0301-1623 |
| Popis: | Due to the well-known intradialytic haemoglobin (Hb) change, it has been suggested that true functional Hb differs from pre-dialysis Hb. However, mechanisms of this change are not understood properly. We aimed at studying the role of plasma volume variation.This is a multicentre study with two consecutive phases. First, true functional Hb was predicted by Krisper's formula that estimates time-averaged haemoglobin concentration (TAC-Hb) and by the average (Avg-Hb) of Pre-Hb and Post-Hb (n = 346). Erythropoiesis-stimulating agent (ESA) doses were estimated according to the FDA instructions. Second, we investigated the correlations between Hb changes (ΔHb), body weight loss (ΔBW) and relative plasma volume changes (%ΔPV) in subjects with a weight gain higher than 1 kg (n = 208).First: Avg-Hb and TAC-Hb were similar to each other and higher than midweek Pre-Hb (p0. 002). Odds of having an Hb change1 g/dL were 0.415. Odds were similar in both women and men [odds ratio (OR) 0.923; 95 % confidence interval (CI) 0.591-1.441]. If ESA doses were estimated by TAC-Hb or Avg-Hb instead of Pre-Hb, they should be lower in 40 % of the 346 patients. Second: Mean %ΔPV was -12.1 % (95 % CI -10.72/-13.48), and mean ΔHb was 1.1 g/dL (95 % CI 0.97/1.25). Correlation between ΔHb and %ΔPV was -0.92 (r (2) 0.84) whereas that of ΔHb/ΔBW was just -0.45 (r (2) 0.21; p0.000). Prevalence of ΔHb1 g/dL was independent of ΔBW from 1.4 to 6.3 kg. By contrast, prevalence of ΔHb1 g/dL in %ΔPV quartiles was clearly linear: 0, 52, 90 and 100 %, respectively.Plasma volume variations play a major role in intradialytic Hb change. True functional Hb should be estimated in all patients with a weight gain higher than 1 kg. |
| Databáze: | OpenAIRE |
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