Hematocrit levels and hospitalization risks in hemodialysis patients

Hong Xia, Jim Ebben, Jennie Z. Ma, Allan J. Collins

Research output: Contribution to journalArticlepeer-review

210 Scopus citations


The association between hematocrit level and future hospitalization risks in hemodialysis patients has not been fully investigated on a national level. A total of 71,717 prevalent Medicare hemodialysis patients who survived a 6-mo entry period from July 1 through December 31, 1993 were studied, and their risk of hospitalizations was evaluated the next year. Five hematocrit groups were defined from Medicare recombinant human erythropoietin-treated patients: <27%, 27 to <30%, 30 to <33%, 33 to <36%, and ≥36%. A Cox regression model was used to investigate the association between hematocrit level and the risk of first hospitalization, and the Andersen-Gill regression model evaluated multiple hospitalizations during the next year, adjusting for patient comorbidity and severity of disease. Compared with the baseline group of 30 to <33%, patients with hematocrit levels <30% had a 14 to 30% increased risk of hospitalization without disease severity adjustment (p = 0.0001) and a 7 to 18% increased risk with disease severity adjustment (p = 0.0001). Patients in the 33 to <36% group had the lowest risk at 0.93 and 0.88 (p = 0.0001), with and without adjustment for disease severity. It is concluded that patients with hematocrits of <30% have an in- creased risk of future hospitalization, with hematocrit levels between 33 and 36% having the lowest associated risks.

Original languageEnglish (US)
Pages (from-to)1309-1316
Number of pages8
JournalJournal of the American Society of Nephrology
Issue number6
StatePublished - Jun 1 1999


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