Factors Influencing Hemoglobin Variability and Its Association With Mortality in Hemodialysis Patients

Study Overview
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Brief Summary
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The aim of the study is to investigate the factors influencing hemoglobin variability with inflammatory and nutritional parameters and its associations with all-cause mortality among hemodialysis patients.

Detailed Description
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Fluctuation in hemoglobin levels that is known as hemoglobin variability during treatment with ESA is a well-documented phenomenon. Several factors have been found to affect hemoglobin variability, including drug related, such as pharmacokinetic parameters, patient-related differences in demographic characteristics and factors affecting clinical status, as well as clinical practice guidelines, treatment protocols and reimbursement policies. Inflammation is also an important factor associated with hemoglobin variability, and the consequences of persistent inflammatory activity are far-reaching in affected patients. In present study, the factors influencing hemoglobin variability with inflammatory and nutritional parameters and its associations with all-cause mortality among hemodialysis patients are investigated.

Official Title
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Baskent University Nephrology Department

Conditions
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Hemodialysis-Induced Symptom

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age >18 on chronic hemodialysis treatment Exclusion Criteria: All patients had a minimum of six hemoglobin measurements within a 6- month period, and they were excluded if they received a kidney transplant during this period or those who had blood transfusions during the baseline period. Patients with serum ferritin<100 μg/L were also excluded from the study because of reimbursement of our country.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| L Hemoglobin<br>L Hemoglobin: consistently low all 6 months with low hemoglobin levels | |
| T Hemoglobin<br>T Hemoglobin; consistently within the target range all 6 months with target-range hemoglobin levels | |
| H Hemoglobin<br>H Hemoglobin: consistently high all 6 months with high hemoglobin levels | |
| LAL Hemoglobin<br>LAL Hemoglobin: low amplitude fluctuation with low hemoglobin; all 6 months with low or target range hemoglobin levels | |
| LAH Hemoglobin<br>LAH Hemoglobin: low-amplitude fluctuation with high hemoglobin levels 6 months with target-range or high hemoglobin levels) | |
| HA Hemoglobin<br>HA Hemoglobin ; high-amplitude fluctuation low, target-range, and high hemoglobin levels within the 6 month period | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Factors Influencing Hemoglobin Variability and Its Association with Mortality in Hemodialysis Patients | investigation of factors influencing hemoglobin variability with inflammatory and nutritional parameters and the association of hemoglobin variability with all-cause mortality among hemodialysis patients | six month | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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hemodialysis, hemoglobin variability, mortality, nutrition, inflammation