Correlation of Inflammation and Anemia in Patients on Hemodialysis

Abstract

Introduction: Anemia and inflammation are majorly observed complications in patients on hemodialysis (HD). Present study assessed that inflammation that affects the haemoglobin levels in patients with chronic kidney disease (CKD) stage 5 on maintenance HD and to evaluate the degree of anemia.Methods: A retrospective observational study was conducted in CKD patients aged 18-89 years. Previous hospital records were reviewed to note baseline clinical co-morbidities, pre- and post HD -session body weight, dialyzer type, blood flow rate, dialysis time, dialysis prescription (dry body weight, dialysis time, dialysis modality, and dialysate and heparin dose). Results: Out of 46 patients on HD, 31 and 15 were dialyzed with the arteriovenous fistula (AVF) and tunneled cuffed catheters (CTC), respectively. The mean age was 54.59 years and majority had diabetic nephropathy (39.1%). Patients of AVF group showed decreased c-reactive protein (CRP) levels [10.49 (13.25) Vs 26.69 (20.0) mg/L] and higher dialysis vintage (35.50 vs. 15.07 days) as compared to CTC group. A significant negative correlation of CRP with hemoglobin (p<0.0001) and serum albumin (p=0.0005) was observed. CRP levels showed a positive correlation with erythropoietin resistance index (ERI) (p=0.0025). The mean serum CRP levels in patients having hypoalbuminemia (28.87 mg/L) were significantly elevated as compared with patients with normoalbuminemia (10.61 mg/L) (p<0.001). The mean ERI in patients with parathyroid hormone (PTH) value >300 pg/mL was comparatively higher (17.85) as compared to patients with PTH value <300 pg/mL (12.46).Conclusion: Reduced inflammation improves anemia and nutritional status of patients on HD. AVF should be considered as first option for dialysis access.