PMID- 13679484
OWN - NLM
STAT- MEDLINE
DCOM- 20040206
LR  - 20061115
IS  - 0931-0509 (Print)
IS  - 0931-0509 (Linking)
VI  - 18
IP  - 10
DP  - 2003 Oct
TI  - Prediction of time-averaged concentration of haemoglobin in haemodialysis 
      patients.
PG  - 2082-7
AB  - 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.
FAU - Krisper, Peter
AU  - Krisper P
AD  - Division of Nephrology, Department of Internal Medicine, University of Graz, 
      Auenbruggerplatz 27, A-8036 Graz, Austria. peter.krisper@uni-graz.at
FAU - Quehenberger, Franz
AU  - Quehenberger F
FAU - Schneditz, Daniel
AU  - Schneditz D
FAU - Holzer, Herwig
AU  - Holzer H
FAU - Polaschegg, Hans Dietrich
AU  - Polaschegg HD
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - England
TA  - Nephrol Dial Transplant
JT  - Nephrology, dialysis, transplantation : official publication of the European 
      Dialysis and Transplant Association - European Renal Association
JID - 8706402
RN  - 0 (Hemoglobins)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Anemia/*diagnosis/etiology
MH  - Blood Chemical Analysis
MH  - Female
MH  - Hemoglobins/*analysis
MH  - Humans
MH  - Kidney Failure, Chronic/diagnosis/*therapy
MH  - Linear Models
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Predictive Value of Tests
MH  - Probability
MH  - Renal Dialysis/*adverse effects/methods
MH  - Risk Assessment
MH  - Sampling Studies
MH  - Sensitivity and Specificity
MH  - Severity of Illness Index
MH  - Time Factors
EDAT- 2003/09/19 05:00
MHDA- 2004/02/10 05:00
CRDT- 2003/09/19 05:00
PHST- 2003/09/19 05:00 [pubmed]
PHST- 2004/02/10 05:00 [medline]
PHST- 2003/09/19 05:00 [entrez]
AID - 18/10/2082 [pii]
AID - 10.1093/ndt/gfg355 [doi]
PST - ppublish
SO  - Nephrol Dial Transplant. 2003 Oct;18(10):2082-7. doi: 10.1093/ndt/gfg355.