ANEMIA SEVERITY AND MISSED DIALYSIS TREATMENTS IN ERYTHROPOIETIN-TREATED HEMODIALYSIS-PATIENTS

Neither the sociodemographic correlates nor the biochemical/clinical c onsequences of missed dialysis treatments have been well defined. Duri ng a 10 week period, the authors enumerated missed dialysis treatments among 430 patients randomly selected from a pool of 1,395 hemodialysi s patients. A forward logistic regression model was used to determine whether a relationship existed between missed dialysis treatments and the following independent variables: age, gender, race, renal diagnosi s, length of time on maintenance hemodialysis, co-morbidity index, mod ified Karnofsky score, employment status, household residents, and lab oratory indices. Forty-three (10%) of 430 patients missed a total of 9 6 treatments. Despite equivalent treatment with erythropoietin, patien ts who missed dialysis treatment(s) had a lower mean hematocrit (27 +/ - 4.3%) at the end of the study than those patients who underwent all treatments (29 +/- 4.5%) (p = 0.0287). Mean serum albumin and creatini ne levels were equivalent in compliant and noncompliant patients. Rece nt starts (p = 0.0048), and younger patients (p = 0.0424) were most li kely to miss dialysis treatment(s). One of the major consequences of m issed dialysis treatment(s) is exacerbation of anemia, and younger pat ients and freshly started patients are more likely to miss scheduled d ialysis treatments than their respective counterparts.