Introduction: Anemia is a common complication in patients with end-stage renal disease, especially those on dialysis. Several factors, such as consumed erythropoietin production, iron deficiency, and inflammation, contribute to anemia in these patients. The treatment of anemia differs between hemodialysis (HD) and peritoneal dialysis (PD). HD is associated with blood loss through the extracorporeal circuit, while PD patients generally have better residual renal function and do not experience blood loss. These differences suggest that PD patients may have better control of anemia. Since the care for patients on dialysis has improved in recent years and there are no Brazilian data in this field, we aimed to compare the prevalence of anemia between PD and HD patients.
Methods: This was a cross-sectional study. The laboratory variables evaluated were hemoglobin, ferritin, and the transferrin saturation index. We included all patients who had been on dialysis for at least two months between September 2022 and September 2023. Anemia was defined as hemoglobin level < 10mg/dL.
Results: We included 58 patients on PD and 146 on HD. Comparison between PD and HD revealed no difference in age (p=0.104) or sex distribution (p=0.565). Hemoglobin levels were lower among patients on HD than PD, although this was not significant (10.5 ± 1.7 vs. 11.0 ± 1,7 mg/dL, p=0.069). There was no difference in iron or transferrin saturation between groups. Serum ferritin was higher among patients on HD [372 (184, 643) vs. 121 (64, 392) ng/mL, p=0.008]. Repeated measures over the year showed no significant change in hemoglobin levels among patients on PD (p=0.492) but this was not the case in those on HD (p<0.001). The prevalence of anemia was similar between HD and PD (35.0% vs. 25.5%, respectively, p=0.200).
Conclusion: We found a similar prevalence of anemia and hemoglobin levels between patients on HD and PD, despite higher levels of ferritin among patients on HD. This result suggests the need for a more intense supplementation of iron in patients on HD to target hemoglobin levels.
