The role of hemoglobin variability as a prognostic indicator in peritoneal dialysis patients: a retrospective descriptive study

Purpose: To investigate the effect of hemoglobin fluctuations on cardiovascular prognosis of patients on peritoneal dialysis (PD). Methods: Retrospective descriptive study, with sample composed of 333 patients treated with PD at the Renal Unit. Two indicators were adopted to indicate hemoglobin fluctuations of PD patients: absolute value of hemoglobin variability (HV) and HV trend. Moreover, the new cardiovascular events and recurrent rate of cardiovascular events within 3 months after PD were recorded and were compared in groups of PD patients classified by hemoglobin fluctuation indicators. Results: Patients whose HV value is less than 10 g/l have an increased risk of new cardiovascular events than patients with HV value > 10 g/l (27.2 vs. 12.2%, p < 0.05) during 3 months after PD. Patients who kept high hemoglobin values (≥ 110 g/l) 3 months after PD are prone to develop recurrent cardiovascular events than patients with relatively low hemoglobin values (< 110 g/l; p < 0.05). Conclusions: Hemoglobin fluctuations were associated with the cardiovascular prognosis in patients on PD. A limitation of our study is its retrospective design. However, the results in this research indicated anemia in PD patients without cardiovascular events history should be timely treated. Instead, hemoglobin should be kept within a relatively low level in patients with history of cardiovascular events. Additional clinical researches are needed to verify and improve our findings.