关键词: 血液透析, 血红蛋白变异性, 心脑血管事件, 动静脉内瘘血栓形成

Abstract: 【Abstract】Objective To investigate the relationship between hemoglobin variation and incidents of cardiocerebro-vascular events and thrombosis in arteriovenous fistula in maintenance hemodialysis (MHD) patients. Methods A total of 116 MHD patients treated in Peking University Third Hospital in Jan., 2011 were enrolled in this study, and were followed up from July, 2011 to Dec, 2013 or to the end-point events including cardio-cerebro vascular events, arteriovenous fistula thrombosis, and all-cause mortality. Hemoglobin variation was defined as the coefficient of variation of mean hemoglobin in the six months before follow-up period. We then analyzed the relationship between hemoglobin variation and end-point events. Results Cardio-cerebro-vascular events, arteriovenous fistula thrombosis, and all-cause mortality occurred in 56 patients during the follow-up period. All-cause mortality happened in 19 patients, cardiovascular mortality in 9 patients, cardio- cerebro-vascular events in 26 patients, and arteriovenous fistula thrombosis in 11 patients. Kaplan-Meier survival curve analysis indicates that the incidences of cardio-cerebra-vascular events and arteriovenous fistula thrombosis increase in patients with higher hemoglobin variation (coefficient of variation of hemoglobin ＞6.2%) and lower serum albumin (＜38.1g/L). Cox regression analysis shows that coefficient of variation of hemoglobin ＞6.2%, serum albumin ＜38.1g/L and Charlson comorbidity index are the independent risk factors for cardio-cerebro-vascular events and arteriovenous fistula thrombosis. Conclusions Hemoglobin variation and low serum albumin are associated with cardio-cerebro-vascular events and arteriovenous fistula thrombosis in MHD patients.

Key words: Hemodialysis, Hemoglobin variation, Cardio-cerebro-vascular events, Arteriovenous fistula thrombosis