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Selected Publication:
Krisper, P; Quehenberger, F; Schneditz, D; Holzer, H; Polaschegg, HD.
Prediction of time-averaged concentration of haemoglobin in haemodialysis patients.
Nephrol Dial Transplant. 2003; 18(10):2082-2087
Doi: 10.1093/ndt/gfg355
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- Leading authors Med Uni Graz
- Krisper Peter
- Co-authors Med Uni Graz
- Holzer Herwig
- Quehenberger Franz
- Schneditz Daniel
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- Abstract:
- BACKGROUND: Haemoglobin (Hb) concentration is not stable in most haemodialysis patients due to ultrafiltration-induced haemoconcentration. Pre-dialysis Hb concentrations might therefore significantly deviate from the time-averaged concentration (Hb-tac) which is more likely to represent the patients 'true' Hb. This study was performed to quantify these differences in our chronic haemodialysis population and to develop a formula for prediction of Hb-tac. METHODS: In 55 stable patients, serial blood samples were taken over a period of 2 weeks before and immediately after each haemodialysis as well as 30 min post-haemodialysis to account for post-dialytic fluid rebound. Hb-tac was calculated for every patient from the area under the time-dependent Hb curve. We compared the differences between Hb-tac and pre-dialysis Hb (Hb-pre) and various prediction formulae for Hb-tac generated by multiple linear regression analysis which included Hb-pre and post-dialysis Hb (Hb-post) and/or ultrafiltration rate (UFR). RESULTS: Mean Hb-pre after the long dialysis interval was significantly lower than after the short interval (11.47 vs 11.85 g/dl, P < 0.0001), both underestimating mean Hb-tac (11.97 g/dl). More interestingly, Hb-pre after the long interval deviated >0.5 g/dl from Hb-tac in 50% of measurements. After the short interval, 20% still lay outside this tolerance range. The best formula to predict Hb-tac was Hb-pre x 0.5 + Hb-post x 0.38 + 1.28 (6% outside +/- 0.5 g/dl). Hb-pre +(Hb-post - Hb-pre)/3 may be used for quick estimation of Hb-tac. CONCLUSIONS: Hb-tac can be predicted from pre- and post-dialysis blood samples after the short interval, using a simple new formula. Because Hb-tac more reliably reflects a 'true' Hb level of haemodialysis patients, it represents a potentially useful tool for future scientific and clinical work.
- Find related publications in this database (using NLM MeSH Indexing)
- Adult -
- Aged -
- Anemia - diagnosis
- Blood Chemical Analysis - diagnosis
- Female - diagnosis
- Hemoglobins - analysis
- Humans - analysis
- Kidney Failure, Chronic - diagnosis
- Linear Models - diagnosis
- Male - diagnosis
- Middle Aged - diagnosis
- Multivariate Analysis - diagnosis
- Predictive Value of Tests - diagnosis
- Probability - diagnosis
- Renal Dialysis - adverse effects
- Risk Assessment - adverse effects
- Sampling Studies - adverse effects
- Sensitivity and Specificity - adverse effects
- Severity of Illness Index - adverse effects
- Time Factors - adverse effects
- Find related publications in this database (Keywords)
- haemodialysis
- haemoglobin
- post-dialysis
- prediction
- target
- time averaged