Intra- and post-dialytic changes of haemoglobin concentrations in non-anaemic haemodialysis patients

Roberto Minutolo, Luca De Nicola, Vincenzo Bellizzi, Carmela Iodice, Roberto Rubino, Filippo Aucella, Carmine Stallone, Felice Nappi, Ferdinando Avella, Eleonora Maione, Giuseppe Conte, Biagio R. Di Iorio

Research output: Contribution to journalArticle

Abstract

Background. Non-anaemic haemodialysis (HD) patients are potentially more prone to the adverse effects of ultrafiltration-induced haemoconcentration. No study, however, has assessed the effects of dialytic session on haemoglobin (Hb) levels in these patients. Methods. The levels of Hb and total protein before, at the end (TO) and up to 120min(T120) after the third HD session of the week were compared in non-anaemic (Hb > 13 g/dl, n = 14, NOR) and anaemic (Hb = 11- 12 g/dl, n = 18, LOW) HD patients. Results. The intradialytic weight loss was similar in the two groups (4.0 ± 0.9 and 4.1 ± 0.9% body weight). During the treatment, Hb levels increased to the same extent in both groups (from 14.4 ± 1.2 to 16.3 ± 1.9 g/dl in NOR, and from 11.4 ± 0.8 to 12.7 ± 0.9 g/dl in LOW) in the presence, presumably, of a smaller plasma volume in NOR, whereas the increment of total protein was greater in NOR (from 7.1 ± 0.2 to 9.6 ± 0.5 g/dl) than in LOW (from 7.3 ± 0.6 to 8.7 ± 0.8 g/dl) (P <0.0001). At T120, the Hb decline in NOR was almost double that measured in LOW (-9.2 ± 3.0 vs -4.7 ± 2.4%, P <0.001). Consequently, Hb concentration did not differ from the pre-dialytic value in NOR (P=0.10), but persisted higher in LOW (P <0.005). The extent of the postdialytic decrement of Hb was inversely related to the total protein values at TO (r = -0.547, P=0.0012). Conclusions. This study indicates that in NOR: (i) the extent of intradialytic increment of Hb is limited by a greater intradialytic plasma refilling; (ii) the greater plasma refilling persists after the end of dialysis, with the restoration of pre-dialytic Hb levels within the initial 2h; and (iii) the force driving this phenomenon resides mainly in the larger changes of total protein concentration.

Original languageEnglish
Pages (from-to)2606-2612
Number of pages7
JournalNephrology Dialysis Transplantation
Volume18
Issue number12
DOIs
Publication statusPublished - Dec 2003

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Renal Dialysis
Hemoglobins
Proteins
Plasma Volume
Ultrafiltration
Weight Loss
Dialysis
Body Weight

Keywords

  • Anaemia
  • Haematocrit
  • Haemodialysis
  • Haemoglobin
  • Plasma refilling
  • Serum protein

ASJC Scopus subject areas

  • Nephrology
  • Transplantation

Cite this

Intra- and post-dialytic changes of haemoglobin concentrations in non-anaemic haemodialysis patients. / Minutolo, Roberto; De Nicola, Luca; Bellizzi, Vincenzo; Iodice, Carmela; Rubino, Roberto; Aucella, Filippo; Stallone, Carmine; Nappi, Felice; Avella, Ferdinando; Maione, Eleonora; Conte, Giuseppe; Di Iorio, Biagio R.

In: Nephrology Dialysis Transplantation, Vol. 18, No. 12, 12.2003, p. 2606-2612.

Research output: Contribution to journalArticle

Minutolo, R, De Nicola, L, Bellizzi, V, Iodice, C, Rubino, R, Aucella, F, Stallone, C, Nappi, F, Avella, F, Maione, E, Conte, G & Di Iorio, BR 2003, 'Intra- and post-dialytic changes of haemoglobin concentrations in non-anaemic haemodialysis patients', Nephrology Dialysis Transplantation, vol. 18, no. 12, pp. 2606-2612. https://doi.org/10.1093/ndt/gfg387
Minutolo, Roberto ; De Nicola, Luca ; Bellizzi, Vincenzo ; Iodice, Carmela ; Rubino, Roberto ; Aucella, Filippo ; Stallone, Carmine ; Nappi, Felice ; Avella, Ferdinando ; Maione, Eleonora ; Conte, Giuseppe ; Di Iorio, Biagio R. / Intra- and post-dialytic changes of haemoglobin concentrations in non-anaemic haemodialysis patients. In: Nephrology Dialysis Transplantation. 2003 ; Vol. 18, No. 12. pp. 2606-2612.
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abstract = "Background. Non-anaemic haemodialysis (HD) patients are potentially more prone to the adverse effects of ultrafiltration-induced haemoconcentration. No study, however, has assessed the effects of dialytic session on haemoglobin (Hb) levels in these patients. Methods. The levels of Hb and total protein before, at the end (TO) and up to 120min(T120) after the third HD session of the week were compared in non-anaemic (Hb > 13 g/dl, n = 14, NOR) and anaemic (Hb = 11- 12 g/dl, n = 18, LOW) HD patients. Results. The intradialytic weight loss was similar in the two groups (4.0 ± 0.9 and 4.1 ± 0.9{\%} body weight). During the treatment, Hb levels increased to the same extent in both groups (from 14.4 ± 1.2 to 16.3 ± 1.9 g/dl in NOR, and from 11.4 ± 0.8 to 12.7 ± 0.9 g/dl in LOW) in the presence, presumably, of a smaller plasma volume in NOR, whereas the increment of total protein was greater in NOR (from 7.1 ± 0.2 to 9.6 ± 0.5 g/dl) than in LOW (from 7.3 ± 0.6 to 8.7 ± 0.8 g/dl) (P <0.0001). At T120, the Hb decline in NOR was almost double that measured in LOW (-9.2 ± 3.0 vs -4.7 ± 2.4{\%}, P <0.001). Consequently, Hb concentration did not differ from the pre-dialytic value in NOR (P=0.10), but persisted higher in LOW (P <0.005). The extent of the postdialytic decrement of Hb was inversely related to the total protein values at TO (r = -0.547, P=0.0012). Conclusions. This study indicates that in NOR: (i) the extent of intradialytic increment of Hb is limited by a greater intradialytic plasma refilling; (ii) the greater plasma refilling persists after the end of dialysis, with the restoration of pre-dialytic Hb levels within the initial 2h; and (iii) the force driving this phenomenon resides mainly in the larger changes of total protein concentration.",
keywords = "Anaemia, Haematocrit, Haemodialysis, Haemoglobin, Plasma refilling, Serum protein",
author = "Roberto Minutolo and {De Nicola}, Luca and Vincenzo Bellizzi and Carmela Iodice and Roberto Rubino and Filippo Aucella and Carmine Stallone and Felice Nappi and Ferdinando Avella and Eleonora Maione and Giuseppe Conte and {Di Iorio}, {Biagio R.}",
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T1 - Intra- and post-dialytic changes of haemoglobin concentrations in non-anaemic haemodialysis patients

AU - Minutolo, Roberto

AU - De Nicola, Luca

AU - Bellizzi, Vincenzo

AU - Iodice, Carmela

AU - Rubino, Roberto

AU - Aucella, Filippo

AU - Stallone, Carmine

AU - Nappi, Felice

AU - Avella, Ferdinando

AU - Maione, Eleonora

AU - Conte, Giuseppe

AU - Di Iorio, Biagio R.

PY - 2003/12

Y1 - 2003/12

N2 - Background. Non-anaemic haemodialysis (HD) patients are potentially more prone to the adverse effects of ultrafiltration-induced haemoconcentration. No study, however, has assessed the effects of dialytic session on haemoglobin (Hb) levels in these patients. Methods. The levels of Hb and total protein before, at the end (TO) and up to 120min(T120) after the third HD session of the week were compared in non-anaemic (Hb > 13 g/dl, n = 14, NOR) and anaemic (Hb = 11- 12 g/dl, n = 18, LOW) HD patients. Results. The intradialytic weight loss was similar in the two groups (4.0 ± 0.9 and 4.1 ± 0.9% body weight). During the treatment, Hb levels increased to the same extent in both groups (from 14.4 ± 1.2 to 16.3 ± 1.9 g/dl in NOR, and from 11.4 ± 0.8 to 12.7 ± 0.9 g/dl in LOW) in the presence, presumably, of a smaller plasma volume in NOR, whereas the increment of total protein was greater in NOR (from 7.1 ± 0.2 to 9.6 ± 0.5 g/dl) than in LOW (from 7.3 ± 0.6 to 8.7 ± 0.8 g/dl) (P <0.0001). At T120, the Hb decline in NOR was almost double that measured in LOW (-9.2 ± 3.0 vs -4.7 ± 2.4%, P <0.001). Consequently, Hb concentration did not differ from the pre-dialytic value in NOR (P=0.10), but persisted higher in LOW (P <0.005). The extent of the postdialytic decrement of Hb was inversely related to the total protein values at TO (r = -0.547, P=0.0012). Conclusions. This study indicates that in NOR: (i) the extent of intradialytic increment of Hb is limited by a greater intradialytic plasma refilling; (ii) the greater plasma refilling persists after the end of dialysis, with the restoration of pre-dialytic Hb levels within the initial 2h; and (iii) the force driving this phenomenon resides mainly in the larger changes of total protein concentration.

AB - Background. Non-anaemic haemodialysis (HD) patients are potentially more prone to the adverse effects of ultrafiltration-induced haemoconcentration. No study, however, has assessed the effects of dialytic session on haemoglobin (Hb) levels in these patients. Methods. The levels of Hb and total protein before, at the end (TO) and up to 120min(T120) after the third HD session of the week were compared in non-anaemic (Hb > 13 g/dl, n = 14, NOR) and anaemic (Hb = 11- 12 g/dl, n = 18, LOW) HD patients. Results. The intradialytic weight loss was similar in the two groups (4.0 ± 0.9 and 4.1 ± 0.9% body weight). During the treatment, Hb levels increased to the same extent in both groups (from 14.4 ± 1.2 to 16.3 ± 1.9 g/dl in NOR, and from 11.4 ± 0.8 to 12.7 ± 0.9 g/dl in LOW) in the presence, presumably, of a smaller plasma volume in NOR, whereas the increment of total protein was greater in NOR (from 7.1 ± 0.2 to 9.6 ± 0.5 g/dl) than in LOW (from 7.3 ± 0.6 to 8.7 ± 0.8 g/dl) (P <0.0001). At T120, the Hb decline in NOR was almost double that measured in LOW (-9.2 ± 3.0 vs -4.7 ± 2.4%, P <0.001). Consequently, Hb concentration did not differ from the pre-dialytic value in NOR (P=0.10), but persisted higher in LOW (P <0.005). The extent of the postdialytic decrement of Hb was inversely related to the total protein values at TO (r = -0.547, P=0.0012). Conclusions. This study indicates that in NOR: (i) the extent of intradialytic increment of Hb is limited by a greater intradialytic plasma refilling; (ii) the greater plasma refilling persists after the end of dialysis, with the restoration of pre-dialytic Hb levels within the initial 2h; and (iii) the force driving this phenomenon resides mainly in the larger changes of total protein concentration.

KW - Anaemia

KW - Haematocrit

KW - Haemodialysis

KW - Haemoglobin

KW - Plasma refilling

KW - Serum protein

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