TÌNH TRẠNG THIẾU MÁU Ở BỆNH NHÂN LỌC MÁU CHU KỲ CÓ SỬ DỤNG THUỐC TẠO MÁU TẠI BỆNH VIỆN PHỤC HỒI CHỨC NĂNG – ĐIỀU TRỊ BỆNH NGHỀ NGHIỆP

Abstract

Background: Anemia is a common complication in patients with end-stage chronic kidney disease (CKD) undergoing maintenance hemodialysis, primarily due to decreased endogenous erythropoietin (EPO) production. Recombinant EPO therapy, combined with intravenous iron supplementation, is the mainstay treatment for maintaining hemoglobin (Hb) levels within the target range. However, many hemodialysis patients fail to achieve target Hb levels despite adherence to therapy. This study aims to assess anemia status and identify contributing factors in CKD patients undergoing maintenance hemodialysis. Objectives: 1. To determine the prevalence of anemia and the proportion of hemodialysis patients receiving erythropoiesis-stimulating agents (ESAs) who fail to achieve target hemoglobin (Hb) levels. 2. To compare selected characteristics between anemic and non-anemic hemodialysis patients receiving ESAs. 3. To identify independent predictors of anemia in hemodialysis patients receiving ESAs. Methods: This cross-sectional study was conducted on hemodialysis patients receiving (ESAs) at the Rehabilitation and Occupational Disease Treatment Hospital in Ho Chi Minh City. Results: The prevalence of anemia among hemodialysis patients receiving ESAs at the Rehabilitation and Occupational Disease Treatment Hospital was 82.1%. Additionally, 23.2% of patients undergoing hemodialysis with ESA therapy failed to achieve target hemoglobin (Hb) levels. Anemia was significantly more prevalent in male patients (p=0.005) and was most commonly observed in the 40–59 age group (p=0.010). It was also more frequent in patients with diabetes mellitus (p=0.036), low transferrin saturation (p=0.005), those requiring frequent ESA administration per week (p<0.001), and those receiving higher ESA doses (p<0.001). Independent predictors of anemia in hemodialysis patients receiving ESAs included male sex (OR: 1.56; 95% CI: 1.25–8.08; p=0.03) and ESA dose (OR: 1.03; 95% CI: 1.01–1.05; p=0.008), with the risk of anemia increasing by 1.03 times for every 1 IU/kg/week increase in ESA dose. Conclusion: A substantial proportion of CKD patients undergoing maintenance hemodialysis fail to achieve target hemoglobin levels despite ESA therapy. More tailored management strategies are needed, particularly for high-risk populations such as male patients and those requiring higher ESA doses.