The Relationship between Body Composition Analysis, Erythropoietin Requirements and Hemoglobin Variability in Hemodialysis Patients

OBJECTIVE: Despite of similar body weight and body mass index patients might have different body composition. Our aim was to analyze the relationship between Hb variability, rHuEPO requirements and body composition analysis of MHD patients. MATERIAL and METHODS: Monthly laboratory values and rHuEPO requirements of 110 MHD patients were collected. Patients were grouped according to Hb variability during last 6 months as Group LS (low stable, Hb<10 g/dL, n: 24), Group HS (high stable, Hb≥10 g/dL, n:43), Group V (variable, Hb varying between target, low target and high target levels, n:43). RESULTS: Group LS had higher CRP but lower albumin levels compared to Group HS while Group V patients had lower albumin compared to HS and lower CRP levels compared to LS patients (p: 0.005). Group LS patients required significantly higher rHuEPO compared to other groups (p:0.0001). Group HS patients had significantly higher muscle mass (p:0.042) and muscle ratio (p:0.018) compared to Group LS. CONCLUSION: Not only chronic inflammation but also nutritional status is closely related with Hb variability. We believe that there is a tendency to lose all body components in case of malnutrition associated with chronic inflammation while in malnutrition patients without chronic inflammation there is a tendency to loose mainly visceral fat component of total fat mass.