The Relationship between Body Composition Analysis, Erythropoietin Requirements and Hemoglobin Variability in Hemodialysis Patients

OBJECTIVE: Despite of similar body weight and body mass index patients might have different body
composition. Our aim was to analyze the relationship between Hb variability, rHuEPO requirements
and body composition analysis of MHD patients.

MATERIAL and METHODS: Monthly laboratory values and rHuEPO requirements of 110 MHD
patients were collected. Patients were grouped according to Hb variability during last 6 months as Group
LS (low stable, Hb<10 g/dL, n: 24), Group HS (high stable, Hb≥10 g/dL, n:43), Group V (variable, Hb
varying between target, low target and high target levels, n:43).

RESULTS: Group LS had higher CRP but lower albumin levels compared to Group HS while Group V
patients had lower albumin compared to HS and lower CRP levels compared to LS patients (p: 0.005).
Group LS patients required significantly higher rHuEPO compared to other groups (p:0.0001). Group
HS patients had significantly higher muscle mass (p:0.042) and muscle ratio (p:0.018) compared to
Group LS.

CONCLUSION: Not only chronic inflammation but also nutritional status is closely related with Hb
variability. We believe that there is a tendency to lose all body components in case of malnutrition
associated with chronic inflammation while in malnutrition patients without chronic inflammation there
is a tendency to loose mainly visceral fat component of total fat mass.