title: Effect of hemoglobin variability on mortality and some cardiovascular parameters in hemodialysis patients.
abstract: OBJECTIVE
  Most hemodialysis patients show hemoglobin fluctuations between low-normal and high levels. This hemoglobin variability may cause left ventricle hypertrophy and may increase mortality as well. Recently, many studies were designed to evaluate the effect of hemoglobin variability on mortality but results were conflicting. We aimed to investigate the effect of hemoglobin variability on mortality and some cardiovascular parameters in hemodialysis population.
  
  
  METHODS
  Hundred and seventy-five prevalent hemodialysis patients classified into three hemoglobin variability groups according to their hemoglobin levels throughout 24 month observation period: Low-Normal, Low-High, Normal-High. Groups were compared in terms of laboratory, demographical data and mortality rates, initial and the end of 24 month echocardiographic data. Initial and last echocardiographic data were compared within groups in terms of left ventricle mass index increase.
  
  
  RESULTS
  Mortality rates and cardiovascular risk factors such as coronary heart disease, diabetes mellitus and hypertension that may affect mortality were same between three groups. There was no significant difference between three groups in terms of echocardiographic and laboratory parameters. Only Low-High group showed significant increase on left ventricle mass index when initial and last echocardiographic parameters were compared.
  
  
  CONCLUSIONS
  Consistent with previous studies, we found that most of the patients exhibited hemoglobin variability and our study is consistent with some of the studies that did not find any relationship between hemoglobin variability and mortality. Firstly, in this study based on objective data, it was shown that hemoglobin variability has adverse effect on left ventricle geometry independent from anemia.
authors.affiliation: Department of Nephrolory, Faculty of Medicine, Kahramanmaraş Sütçü İmam University, Kahramanmaraş, Turkey. orcunaltunoren@hotmail.com
authors.forename: Orcun
authors.initials: O
authors.lastname: Altunoren
authors.forename: Ekrem
authors.initials: E
authors.lastname: Dogan
authors.forename: Hayriye
authors.initials: H
authors.lastname: Sayarlioglu
authors.forename: Gurkan
authors.initials: G
authors.lastname: Acar
authors.forename: Yasemin Coskun
authors.initials: YC
authors.lastname: Yavuz
authors.forename: Naci
authors.initials: N
authors.lastname: Aydın
authors.forename: Murat
authors.initials: M
authors.lastname: Sahin
authors.forename: Murat
authors.initials: M
authors.lastname: Akkoyun
authors.forename: Ismet Onder
authors.initials: IO
authors.lastname: Isik
authors.forename: Ozlem
authors.initials: O
authors.lastname: Altunoren
mesh_terms: D000328:Adult; D000368:Aged; D000740:Anemia / Q000150:complications; D004452:Echocardiography; D005260:Female; D006454:Hemoglobins / Q000378:metabolism*; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000209:etiology*; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000150:complications / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D012189:Retrospective Studies; D014421:Turkey / Q000453:epidemiology
chemical_list: D006454:Hemoglobins