The Relationships Between Intra Dialytic Changes in Hemoglobin Level and Myocardial Injury in Patients With ESRD Undergoing Maintenance Hemodialysis | ||
| Benha Medical Journal | ||
| Articles in Press, Accepted Manuscript, Available Online from 01 November 2025 PDF (770.72 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/bmfj.2025.394660.2532 | ||
| Authors | ||
| Ahmed E. Mansour1; Moaz A. Bakr* 2; El Metwally L. ElShahawy3; Mohamed E. Ibrahim4; Shimaa Moustafa5; Shimaa Salah6 | ||
| 1Assistant professor of internal medicine and nephrology, Faculty of Medicine, Benha University | ||
| 2M.B.B. Ch, M.Sc. Faculty of Medicine, Benha University | ||
| 3Professor of internal medicine and nephrology, Faculty of Medicine, Benha University | ||
| 4professor of internal medicine and nephrology, Faculty of Medicine, Benha University | ||
| 5Lecturer of internal medicine and nephrology, Faculty of Medicine, Benha University | ||
| 6lecturer of internal medicine Faculty of Medicine - Benha University | ||
| Abstract | ||
| Background: HD eliminate toxins from the blood through ultrafiltration and diffusion. This study aimed to Study the correlations between intra-dialytic changes in Hb level (post-HD-Hb/pre-HD-Hb) ratio and myocardial injury in patients with CKD (stage 5) who are undergoing maintenance HD and elucidate intradialytic changes of Hb levels in patients with CKD (stage 5) who are receiving maintenance HD. Methods: This prospective study included 100 patients who were divided into four groups according to baseline Hb level (post-Hb/pre-Hb) ratio: Group 1 (n=30) with post-Hb/pre-Hb ratio <1.0, group 2 (n=20) with post-Hb/pre-Hb ratio 1.0 to <1.1, group 3 (n=20) with post-Hb/pre-Hb ratio 1.1 to <1.2 and group 4 (n=30) with post-Hb/pre-Hb ratio ≥1.2. While 4 groups according to post HD Hb level: Group A (n=30) with post Hb level <10 g/dL, group B (n=20) with post Hb level 10 g/dL to < 11 g/dL, group C (n=20) with post Hb level 11 g/dL to < 12 g/dL and group D (n=30) with post Hb level >12 g/dL. Results: hs-cTnT at a cut-off of 12 demonstrated the highest diagnostic accuracy, with the greatest AUC (0.808), balanced sensitivity (75%) and specificity (81.6%), and a high NPV (91.2%), making it a reliable tool for ruling out myocardial injury. hs-cTnI at a cut-off of 8.9 showed a slightly lower AUC (0.796) and specificity (78.9%), comparable sensitivity (75%) and NPV (90.9%), suggesting it is also effective, though slightly less so than hs-cTnT. Conclusion: The asymptomatic raising of hscTni, hscTnt and ckmb represent silient myocardial injury during HD. | ||
| Keywords | ||
| Hemodialysis; hemoglobin changes; ΔHb; cardiovascular outcomes; cardiac biomarkers | ||
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