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Nephrol Ther. 2008 Dec;4(7):549-52. doi: 10.1016/j.nephro.2008.04.010. Epub 2008 Nov 11.

[Hemoglobin variability in patients with chronic renal insuffiency].

[Article in French]

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Service de néphrologie, groupe hospitalier Pitié-Salpêtrière, 83, boulevard de l'Hôpital, 75013 paris, France.


Several recent articles have examined the time-dependent effects of epoetin therapy and the variability of hemoglobin (HGb) levels and what epoetin does in hemodialysis patients. A recent preliminary report also found that HGG cycling was common among hemodialysis patients, with only 10% of patients remaining within their initial HGb range (less than 11 g/dl, 11 to 12.5 g/dl, greater than 12.5 g/dl) during a six-month period. Factors associated with HGb cycling were changes in epoetin dose, intravenous-iron administration or a change in dose and hospitalization. What is not known is whether there are adverse clinical outcomes associated with HGb variability, although preliminary data indicate, perhaps predictably, that a decreasing HGb level is associated with a higher mortality risk. This is certainly an area that merits further study.

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