Abstract: 【Abstract】 Objective To investigate the hemoglobin (Hb) measurement frequency on the detection of Hb variation, and the correlation between Hb variation and mortality in maintenance hemodialysis (MHD) patients. Methods Maintenance hemodialysis patients treated in the Department of Nephrology, Shanghai Ruijin Hospital from Jan. 1st, 2011 were followed up. Hb measurement was performed once every 2 months from Jan. 2011 to Dec. 2012, and once every month from Jan. 2013 to July. 2014. Hb measurement frequency on the detection of Hb variation in these patients was then evaluated. Hb variation was described by residual standard deviation (Res-SD), fluctuation across threshold of the Hb level, and Hb variation amplitude. In the retrospective study, we analyzed Hb variation in MHD patients treated in the period from Jan. 2013 to June 2013, as well as the correlation between Hb variation and mortality using cardiovascular events and all-cause death as the study endpoints. Results Hb variation was higher in the patients with Hb measurement once every 2 months than in those with Hb measurement once every month (P＜0.05). Hb fluctuated in low amplitude around the lower limit of the targeted Hb level in 56.7% patients with Hb measurement once every 2 months and in 68.7% patients with Hb measurement once every month. Correlation analysis showed that age was the major and statistically significant influencing factor for Hb variation. After exclusion of age factor, the patients with low Hb level had higher mortality rate as compared to those with high amplitude Hb fluctuation (OR=6.186, 95% CI 1.277～29.956, P=0.024). Conclusion The increase of Hb measurement frequency can obviously reduce the possibility of Hb variation. Higher Hb variation was unrelated to mortality. However, mortality increased in MHD patients with low amplitude fluctuation around the lower limit of the targeted Hb level

Key words: maintenance hemodialysis, Hemoglobin detection frequency, hemoglobin variability, mortality