Pathogenetic features of systemic hypoxia in patients with chronic kidney disease stage 5d on hemodialysis

Material and methods. Eighty patients with CKD 5D on programmed hemodialysis were examined. The study group was represented by 47 men and 33 women, mean age was 51.7±11.6 years, the duration of history of dialysis was 33.5 (19.7-58.25) months. Clinical examination included the assessment of patient complaints, anthropometric examination, and bioimpedancemetry. The HIF-1α level was determined by the quantitative enzyme immunoassay once for all patients of the study group using the Hypoxia-inducible factor (HIF-1α) ELISA Kit (USA). Results. The blood HIF-1α concentration in patients of the study group ranged from 0.16 to 0.27 ng/ml (К-s Index = 0.26; P<0.01; lllliefors P<0.01), the median was 0.17 (0.16; 0.21) ng/ml. There was no independent contribution of anemia to the development of systemic hypoxia: Teh GROUPS DID NOT SIGNIFICANTLY DIFFER IN HEMOGLOBIN LEVELS, AND THE CORRELATION WITH THE HIF LEVEL WAS NOT STATISTICALLY significant within groups (P>0.05). Target hemoglobin levels were achieved by 34/42 (80.95%) and 32/38 (84.2%) PATIENTS; IN THE GROUP WITH ELEVATED HIF-1α, HOWEVER, MODERATE-TO-SEVERE ANEMIA WAS SIGNIFICANTLY FREQUENT: IN 4/42 (10%) and 1/38 (3%) patients, respectively. All patients had an elevated P2-microglobulin level, and there was a weak correlation with the HIF-1α index (r=-0.26; P<0.05), which was confirmed by the difference in the mean values of this index in the groups (24.9±5, 98; 27.61±5.44; P=0.041). Conclusion. The absence of a significant effect of anemia on the HIF-1α level may be associated with different durations of CKD history, previous therapy with erythropoiesis-stimulating agents, and disorders of ferrokinetics.

HIF-1a, chronic kidney disease (CKD), hypoxia, HIF-1α, impedancemetry, anemia