ORIGINAL RESEARCH article
Front. Med.
Sec. Nephrology
This article is part of the Research TopicManagement of Patients with Dialysis Dependent Chronic Kidney Disease (DD-CKD)View all 14 articles
Analysis of Factors Influencing Hemoglobin Target Achievement in Maintenance Hemodialysis Patients in Wuhan, China
Provisionally accepted
- 1The Fifth Hospital of Wuhan, Wuhan, China
- 2Wuhan No 1 Hospital, Wuhan, China
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Introduction :This study identified key factors influencing hemoglobin (Hb) target achievement (≥110 g/L) in maintenance hemodialysis (MHD) patients in Wuhan to guide improvement strategies. Methods: A multicenter retrospective study (January 2019—December 2023) included 4906 MHD patients from 70 dialysis centers in Wuhan. Data on demographics, dialysis-related parameters, pre-dialysis laboratory indices, and medication use were collected. Patients were categorized into target (Hb≥110 g/L) and non-target group (Hb<110 g/L). Group differences were analyzed, and binary multivariate logistic regression identified independent factors. Results: A total of 4906 MHD patients from 70 dialysis centers were included in this study. Multivariate logistic regression analysis identified female sex (OR = 1.18, P = 0.011), TCC use (OR = 1.23, P = 0.006), dialysis frequency <3 times/week (OR = 1.20, P = 0.006), pre-dialysis hypertension (OR = 1.28, P < 0.001), lack of LC use (OR = 1.16, P = 0.043), higher serum phosphorus (pre 0.1mmol/L OR = 1.02, P < 0.001) and CRP (pre 1 mg/dL OR = 1.01, P < 0.001) as independent risk factors for not achievement. Independent protective factors included LMWH use (OR = 0.59, P = 0.002), coverage under employee medical insurance (OR = 0.74, P = 0.033), higher serum albumin (pre 1 g/L OR = 0.90, P < 0.001), calcium (per 0.1 mmol/L OR = 0.95, P < 0.001), and TSAT (pre 1% OR = 0.99, P < 0.001). 2 Conclusion: Hb target achievement in Wuhan MHD patients is influenced by a complex interplay of demographic (sex), clinical (vascular access type, dialysis adequacy and frequency, blood pressure management, inflammatory status, mineral/nutrition/iron status), therapeutic (LMWH and LC management), and socioeconomic factors (insurance). Targeting modifiable factors is crucial for optimizing anemia management.
Keywords: Maintenance hemodialysis, Hemoglobin target achievement, Anemia management, Influencing factors, Clinical variables
Received: 14 Jul 2025; Accepted: 12 Dec 2025.
Copyright: © 2025 Liu, Min, Nan, Liu, Wang and Xiong. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Xiaohui Wang
Fei Xiong
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