Hemoglobin variability is a strong predictor of death risk in hemodialysis patients, according to a study—“Hemoglobin Variability and Mortality in ESRD” (.pdf; 208Kb)—published in the December issue of the Journal of the American Society of Nephrology. Hemoglobin carries oxygen in the blood to every part of the body. Anemia—low hemoglobin levels—is one of the most frequent complications of end-stage renal disease (ESRD) and a common cause of death in hemodialysis patients.
Treatments for anemia in hemodialysis patients included erythropoietin and intravenous iron.
Data from 34,963 hemodialysis patients was used to analyze variations in hemoglobin levels. The new metric, “Hb-Var,” measures hemoglobin variability independently of their absolute values and trends over time.
The study found that high Hb-Var, or a high hemoglobin variability, predicated a greater risk of death. For each 1 gram per deciliter (g/dL) increase in Hb-Var, the risk of death increased by 33 percent. A drop in hemoglobin levels impairs the body’s ability to transport adequate levels of oxygen to the organs, causing damage. According to the study, the heart and autonomic nervous system may be especially vulnerable to wide variations in hemoglobin levels.
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