서울 서남부지역 혈액투석 환자의 빈혈 및 칼슘-인 대사 현황

Abstract

Background/Aims The number of hemodialysis patients and dialysis centers is increasing each year, but there are no quality standards for facilities. Thus, the Korean Society of Nephrology carried out a pilot project regarding a hemodialysis center accreditation system. This study was aimed at surveying the prevalence of anemia and abnormalities of calcium or phosphorus metabolism in hemodialysis patients in southwestern Seoul.

Methods We investigated anemia, serum calcium, and phosphorus levels in 1,524 patients in 25 hemodialysis units. The rate of iron injections in patients with iron deficiency was also evaluated. Each item was compared between accredited (n = 12) and non-accredited centers (n = 13).

Results The mean hemoglobin in subjects was 10.5 ± 1.5 g/dL. The prevalences of anemia and iron deficiency were 27.4% and 25.2%, respectively. The rate of iron injection in patients with iron deficiency was 48.1%. The mean phosphorus level was 5.1 ± 1.9 mg/dL and the proportion of patients with Ca × P < 55 mg2/dL2 was 70.7%. The prevalence of anemia, iron deficiency, and Ca × P were similar between accredited and non-accredited centers. The rate of iron injection in iron deficiency was higher in accredited (65.6%) than non-accredited centers (30.9%).

Conclusions Management of anemia and levels of calcium or phosphorus were acceptable in hemodialysis patients in southwestern Seoul, although some facilities should make more efforts to improve iron deficiency. The availability of data from a hemodialysis center accreditation system allowed us a unique opportunity to further explore the relationships between anemia, abnormalities of mineral metabolism, and outcomes.