scholarly journals Haemolysis in Patients with End-Stage Renal Disease Receiving Haemodialysis: A Cross-Sectional Study

2020 ◽  
Author(s):  
Koichiro Matsumura ◽  
Toshika Okumiya ◽  
Tetsuro Sugiura ◽  
Nobuyuki Takahashi ◽  
Yoshihiro Yamamoto ◽  
...  

Abstract Background: Haemolysis due to mechanical stress on red blood cells (RBCs) during extracorporeal circulation has been reported in patients receiving haemodialysis. However, little is known about the incidence of, and the mechanisms underlying haemolysis in patients receiving maintenance haemodialysis. We sought to investigate the incidence and underlying mechanisms of haemolysis in patients with end-stage renal disease undergoing maintenance dialysis by measuring erythrocyte creatine.Method: In a cross-sectional study, we evaluated 69 patients with end-stage renal disease receiving haemodialysis (n = 55) or peritoneal dialysis (n = 14). Erythrocyte creatine, a quantitative marker of mean RBC age, was measured with other haemolytic markers including haptoglobin, reticulocyte count and lactate dehydrogenase.Results: RBC age was significantly shorter [47.7 (43.2–52.8) days vs. 59.8 (56.0–66.2) days, p<0.0001], and haptoglobin was significantly lower in haemodialysis patients than in those with peritoneal dialysis, although haemoglobin levels were comparable in the two groups. When haemodialysis patients were stratified by median RBC age (47.7 days), patients with shortened RBC age had higher intradialytic ultrafiltration rates, larger erythropoiesis-stimulating agent doses, and a higher erythropoietin resistance index compared to that of those with preserved RBC age.Conclusions: Haemolysis exists in patients receiving maintenance haemodialysis, especially in those with greater intradialytic fluid extraction.

2020 ◽  
Author(s):  
Koichiro Matsumura ◽  
Toshika Okumiya ◽  
Tetsuro Sugiura ◽  
Nobuyuki Takahashi ◽  
Yoshihiro Yamamoto ◽  
...  

Abstract Background: The causes of anaemia in patients with end-stage renal disease include a relative deficiency in erythropoietin production and complex clinical conditions. We aimed to investigate the underlying mechanisms of anaemia in patients with end-stage renal disease who were undergoing maintenance dialysis by measuring erythrocyte creatine levels.Methods: In a cross-sectional study, we evaluated 69 patients with end-stage renal disease who were receiving haemodialysis (n = 55) or peritoneal dialysis (n = 14). Erythrocyte creatine level, a quantitative marker of mean red blood cell (RBC) age, was measured.Results: The mean RBC age was significantly shorter in the haemodialysis group than in the peritoneal dialysis group (47.7 days vs. 59.8 days, p<0.0001), although the haemoglobin levels were comparable between the groups. A Spearman correlation coefficient analysis revealed that shortened RBC age positively correlated with transferrin saturation (r = 0.54), ferritin level (r= 0.47), and haptoglobin level (r = 0.39) but inversely related with reticulocyte (r = −0.36), weekly doses of erythropoiesis-stimulating agents (ESAs; r = −0.62), erythropoietin resistance index (r = −0.64), and intradialytic ultrafiltration rate (r = −0.32).Conclusions: Shortened RBC age was observed in patients who were receiving maintenance haemodialysis and was associated with iron deficiency, greater haptoglobin consumption, higher ESA requirements, and poor erythropoietin responsiveness, as well as with greater intradialytic fluid extraction.


2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Koichiro Matsumura ◽  
Toshika Okumiya ◽  
Tetsuro Sugiura ◽  
Nobuyuki Takahashi ◽  
Yoshihiro Yamamoto ◽  
...  

Abstract Background The causes of anaemia in patients with end-stage renal disease include a relative deficiency in erythropoietin production and complex clinical conditions. We aimed to investigate the underlying mechanisms of anaemia in patients with end-stage renal disease who were undergoing maintenance dialysis by measuring erythrocyte creatine levels. Methods In a cross-sectional study, we evaluated 69 patients with end-stage renal disease who were receiving haemodialysis (n = 55) or peritoneal dialysis (n = 14). Erythrocyte creatine level, a quantitative marker of mean red blood cell (RBC) age, was measured. Results The mean RBC age was significantly shorter in the haemodialysis group than in the peritoneal dialysis group (47.7 days vs. 59.8 days, p < 0.0001), although the haemoglobin levels were comparable between the groups. A Spearman correlation coefficient analysis revealed that shortened RBC age positively correlated with transferrin saturation (r = 0.54), ferritin level (r = 0.47), and haptoglobin level (r = 0.39) but inversely related with reticulocyte (r = − 0.36), weekly doses of erythropoiesis-stimulating agents (ESAs; r = − 0.62), erythropoietin resistance index (r = − 0.64), and intradialytic ultrafiltration rate (r = − 0.32). Conclusions Shortened RBC age was observed in patients who were receiving maintenance haemodialysis and was associated with iron deficiency, greater haptoglobin consumption, higher ESA requirements, and poor erythropoietin responsiveness, as well as with greater intradialytic fluid extraction.


2020 ◽  
Author(s):  
Koichiro Matsumura ◽  
Toshika Okumiya ◽  
Tetsuro Sugiura ◽  
Nobuyuki Takahashi ◽  
Yoshihiro Yamamoto ◽  
...  

Abstract Background: The causes of anaemia in patients with end-stage renal disease include a relative deficiency in erythropoietin production and complex clinical conditions. We aimed to investigate the underlying mechanisms of anaemia in patients with end-stage renal disease who were undergoing maintenance dialysis by measuring erythrocyte creatine levels.Methods: In a cross-sectional study, we evaluated 69 patients with end-stage renal disease who were receiving haemodialysis (n = 55) or peritoneal dialysis (n = 14). Erythrocyte creatine level, a quantitative marker of mean red blood cell (RBC) age, was measured.Results: The mean RBC age was significantly shorter in the haemodialysis group than in the peritoneal dialysis group (47.7 days vs. 59.8 days, p<0.0001), although the haemoglobin levels were comparable between the groups. A Spearman correlation coefficient analysis revealed that shortened RBC age positively correlated with transferrin saturation (r = 0.54), ferritin level (r= 0.47), and haptoglobin level (r = 0.39) but inversely related with reticulocyte (r = −0.36), weekly doses of erythropoiesis-stimulating agents (ESAs; r = −0.62), erythropoietin resistance index (r = −0.64), and intradialytic ultrafiltration rate (r = −0.32).Conclusions: Shortened RBC age was observed in patients who were receiving maintenance haemodialysis and was associated with iron deficiency, greater haptoglobin consumption, higher ESA requirements, and poor erythropoietin responsiveness, as well as with greater intradialytic fluid extraction.


2020 ◽  
Author(s):  
Koichiro Matsumura ◽  
Toshika Okumiya ◽  
Tetsuro Sugiura ◽  
Nobuyuki Takahashi ◽  
Yoshihiro Yamamoto ◽  
...  

Abstract Background: Cause of anaemia in end-stage renal disease is not only due to relative deficiency in erythropoietin production, but also to the complex clinical conditions. We sought to investigate the underlying mechanisms of anaemia in patients with end-stage renal disease undergoing maintenance dialysis by measuring erythrocyte creatine.Methods: In a cross-sectional study, we evaluated 69 patients with end-stage renal disease receiving haemodialysis (n = 55) or peritoneal dialysis (n = 14). Erythrocyte creatine, a quantitative marker of mean red blood cell (RBC) age, was measured.Results: Mean RBC age was significantly shorter in haemodialysis patients than in those with peritoneal dialysis (47.7 days vs. 59.8 days, p<0.0001), although haemoglobin levels were comparable between the groups. Spearman correlation coefficient analysis revealed that transferrin saturation (r = 0.54), ferritin (r= 0.47), and haptoglobin (r = 0.39) were positively, whereas reticulocyte (r = -0.36), weekly dose of erythropoiesis-stimulating agent (r = -0.62), erythropoietin resistance index (r = -0.64), and intradialytic ultrafiltration rate (r = -0.32) were inversely related to shortened RBC age.Conclusions: Shortened RBC age was observed in patients receiving maintenance haemodialysis. Shortened RBC age was associated with iron deficiency, greater haptoglobin consumption, higher ESA requirements, and poor erythropoietin responsiveness as well as greater intradialytic fluid extraction.


2020 ◽  
Vol 58 (226) ◽  
Author(s):  
Kajan Raj Shrestha ◽  
Dinesh Gurung ◽  
Uttam Krishna Shrestha

Introduction: Arteriovenous fistula is the most common vascular access for patients requiringhemodialysis, but it is not always possible or practical hence cuffed tunneled dialysis cathetercomes into play. The aim of the study was to determine the outcome of cuffed tunneled dialysiscatheter used for hemodialysis at a teaching hospital. Methods: A descriptive cross-sectional study was conducted between January 2014 and December2019 on 103 chronic dialysis patients with end-stage renal disease presenting to a tertiary carehospital. Ethical approval was received from the institutional review board (2/(6-11) E2/076/77).Whole sampling was done. Data entry and analysis were done in Microsoft Excel 10. Results: The study included 103 patients with 117 cuffed tunneled dialysis catheters placed forhemodialysis. On assessing the outcome of the catheters, the primary and secondary patencyrates of the catheters were 5.85±4.87 and 1.21±3.77 months. Thirty-one (30.1%) patients requiredone intervention, and 11 (10.68%) catheters required 3 or more interventions to maintain patency.Eighteen (17.48%) patients presented with catheter dysfunction while in 11 (10.68%) cases, thecatheter was kinked or malpositioned at the notch. In one patient, procedure was abandoned dueto severe bleeding and in 2 (1.94%) patients dialysis catheters could not be negotiated into the rightatrium and left in brachiocephalic junction. Conclusions: Cuffed tunneled dialysis catheter is effective for maintenance hemodialysis in patientswith the end-stage renal disease if used with proper care during dialysis even in our setup. Theresults and outcomes of the procedure are at par with standards.


Sign in / Sign up

Export Citation Format

Share Document