Influence of anemia on hospitalization and mortality in hemodialysis patients

The objective of our study was to evaluate the influence of anemia on hospitalization and mortality in hemodialysis patients of Kaunas region. We analyzed ambulatory case records of 148 patients dialyzed in all 7 hemodialysis centers of Kaunas region in November 2001. The study consisted of two parts: in the first part data on patient age, gender, primary cause of end-stage renal disease, hemoglobin concentration were collected in November 2001 and in the second part these patients were followed up for 12 months in order to evaluate rate and length of hospitalization, reasons for hospitalization and mortality. At the beginning of the study mean hemoglobin (Hb) value was 101.2±13.8 g/l and more than a half of the patients (59%) had hemoglobin value higher than 100 g/l. Further follow-up of the patients during the year 2002 revealed that hemoglobin level of the patients who died was lower from the patients who followed hemodialysis. Mean hemoglobin of dead and alive patients was 92.4±18.6 g/l and 102.81±12.48 g/l, respectively (p=0.02). Lower hemoglobin concentrations were associated with a 5% higher relative risk of mortality for every 1 g/l decrease in hemoglobin (p=0.027). Analysis showed that mean hemoglobin value was 104.2±11.1 g/l for the patients who were not hospitalized and 99±15.1 g/l for the patients who were hospitalized during the year 2002 (p=0.02). Lower hemoglobin concentrations were associated with a 5% higher relative risk for hospitalization for every 1 g/l decrease in hemoglobin (p=0.027). Patients who had mean hemoglobin value lower than 100g/l were hospitalized more frequently (p=0.01) and for longer period of time (p=0.005) than the patients with hemoglobin higher than 100 g/l. Analysis of the reasons for hospitalizations revealed that every 1 g/l decrease in hemoglobin increases relative risk for hospitalization due infections by 1% (p=0.000)