Blood Hemoglobin Change During Maintenance Hemodialysis Sessions.

BACKGROUND

Blood hemoglobin (Hb) levels typically increase during maintenance hemodialysis (MHD) sessions. This intradialytic Hb change (ID-HbC) may increase thrombotic risks depending on its magnitude. This study investigated the magnitude.

METHODS

In 115 MHD sessions with standard hemodialysis modality, relative-ID-HbC, which was calculated from pre- and post-dialysis Hb values, was examined in relation to ultrafiltration volume normalized to dry weight (UFV/DW).

RESULTS

Relative-ID-HbC ranged from -0.037 to 0.324, with a median (interquartile range) of 0.104 (0.070-0.177). A significant positive correlation was observed between relative-ID-HbC and UFV/DW (r = 0.50, p < 0.001), with a least-squares regression slope of 3.1. In about 1/3 sessions with UFV/DW > 0.05, relative-ID-HbC exceeded 0.2.

CONCLUSION

More than 20% increase in Hb can occur in sessions with UFV/DW > 0.05, whereas the typical increase is around 3% per 1% increase in UFV/DW. To reduce thrombotic risks, anemia therapy raising pre-dialysis Hb > 10.5 g/dL should preferably be avoided in MHD patients who require UFV/DW > 0.05.