关键词: 维持性血液透析,肾性贫血,血红蛋白达标,绝对性铁缺乏

Abstract: Ｏｂｊｅｃｔｉｖｅ：To investigate the compliance of hemoglobin and iron metabolism in maintenance hemodialysis (MHD) patients in various areas of Sichuan province, and to provide reference for improving the compliance rate of anemia in MHD patients in this area.
Ｍｅｔｈｏｄｏｌｏｇｙ：A total of 7190 MHD patients in 41 dialysis centers in Sichuan were enrolled in this study. Hemoglobin, ferritin, transferrin saturation, total iron binding capacity and other indicators were collected, to analyze the hemoglobin compliance rate and the distribution of iron metabolism parameters in MHD patients.
Ｒｅｓｕｌｔｓ：A total of 7 190 patients in 41 hemodialysis centers were included in the final analysis, including 589％ males, 57 (49～69) years of median age, 2 451 patients were reaching the standard, with a compliance rate of 341％ (95％CI 330％～352％). The compliance rate was different in different regions (P<00001), 318％ (95％CI 295％～340％) in northern Sichuan, 368％ (95％CI 342％～395％) in southern Sichuan, 301％ (95％CI 276％～326％) in western Sichuan, 361％ (95％CI 334％～387％) in eastern Sichuan and 359％ (95％CI 336％～381％) in central Sichuan. A total of 2292 patients had Hb < 110 g／L, including 147 (144％) with macrocytic anemia, 751 (737％) with normocytic normochromic anemia, 23 (23％) with microcytic anemia alone, and 98 (96％) with microcytic hypochromic anemia. The compliance rate was 320％ (95％CI 304％～337％) in female patients, 355％ (95％CI 341％～370％) in male patients. Women had a lower compliance rate than men, and the difference was statistically significant (P=0002). There was a significant difference in gender (χ2=9412, P=0002). The compliance rate of hemodialysis centers was 332％ (95％CI 315％～349％) in tertiary hospitals and 347％ (95％CI 333％～362％) in nontertiary hospitals, the difference was not statistically significant (P=0121); The risk of substandard hemoglobin was increased (OR=1167, 95％CI 1057~1290). Serum iron 114 (84～154) IU／ml, ferritin 1633 (604～3219) μg／L, transferrin saturation 255％ (188％～341％), total iron binding capacity 484 (395~568) μg／dL; patients with absolute iron deficiency accounted for 189％ (169％～209％), patients achieving hemoglobin targets accounted for 349％ (292％～407％); patients with nonabsolute iron deficiency achieved hemoglobin targets accounted for 373％ (345％～401％), and the difference was not statistically significant (P=0560).
Ｃｏｎｃｌｕｓｉｏｎ：The compliance rate of hemoglobin in MHD patients in Sichuan is low, with regional differences. The compliance rate in females is lower than that in males, and more than half of MHD patients have absolute iron deficiency.

Key words: maintenance hemodialysis,renal anemia,hemoglobin control,absolute iron deficiency