Impact of hemoglobin on the mortality and hospitalization of patients with chronic kidney disease on hemodialysis

Aguilar-Acebedo D.; Guzmán-Ventura W. · Revista Colombiana de Nefrologia (2025) · DOI: 10.22265/acnef.12.1.783

Resumen

Background: Patients with chronic kidney disease (CKD) in hemodialysis have a higher hospitalization and mortality rate than the general population; therefore, studying the contribution of different risk factors is a priority. Hemoglobin alteration is common in CKD and is related to cardiovascular complications, which are the leading cause of death. However, there is no consensus on the appropriate hemoglobin values for CKD. Purpose: To determine if altered hemoglobin levels are related to hospitalization and mortality in patients with CKD on hemodialysis. Methodology: Observational retrospective cohort study that included 214 patients who started he-modialysis between 2019 and 2022. Hemoglobin levels at the start of hemodialysis were classified as altered (≤10 and/or >12 g/dL) or reference (>10 to 12 g/dL) and were correlated with hospitalization and mortality using bivariate analysis with the Pearson chi-square test and multivariate analysis with the Cox regression model, with a significance level of p<0.05. Results: A total of 214 CKD patients on hemodialysis were included in the study. Among them, 55 (48.2 %) patients with altered hemoglobin were hospitalized, compared to 16 (16.0 %) with reference hemoglobin (p<0.001). Additionally, 41 (36.0 %) patients with altered hemoglobin died, compared to 5 (5.0 %) with reference hemoglobin (p<0.001). In the remaining patients, no hospitalizations or mortality were reported during the course of the study. The relative risk of hospitalization for patients with altered hemoglobin was 3.02 (95 % CI: 1.85-4.91), and the relative risk of mortality for patients with altered hemoglobin was 7.19 (95 % CI: 2.96-17.49). In the multivariate analysis, altered hemoglobin, hypoalbuminemia, and hyperphosphatemia were associated with a higher mortality and hospitalization risk. Conclusions: Altered hemoglobin increases the risk of hospitalization and mortality in hemodialysis patients.

Instituciones: Universidad Privada Antenor Orrego