The Effect of Altitude Change on Anemia Treatment Response in Hemodialysis Patients

摘要: Hemodialysis patients who live at high altitude use less exogenous erythropoietin but achieve higher hematocrit levels than those living a lower altitude. The authors hypothesized that the effect of would be strongest in hemodialysis with poor anemia treatment response. To explore this hypothesis, they studied anemiarelated outcomes US move to altitudes. Using Medicare and Geological Survey data, 1992–2004 identified instances which patient moved from dialysis center an <2,000 feet (600 m) one elevation. Of these moves, 5,274 were � 3,000 (900 m; group) 25,345 250–500 (75–150 control group). Among response baseline, large increases decreases dosing observed relative group. At 6 months, had increased more group (5.1%, 95% confidence interval (CI): 4.1, 6.2 vs. 3.7%, CI: 3.5, 3.9), decreased (4,600 units/week, 500, 8,700 1,700 1,000, 2,400). No was better baseline. These results support hypothesis altitude-induced hypoxia reduces requirements treatment-refractory anemia.