Relationships between hemoglobin and hematocrit levels and hospitalization and survival rates in dialysis patients.

Preserving life and reducing or limiting morbidity are the primary goals of dialysis therapy and the focus of day-to-day nursing assessments and interventions. A series of clinical analyses have shown that partial correction of anemia (to maintain hemoglobin [Hb] in the range of 11 to 12 g/dL and hematocrit [Hct] levels in the range of 33% to 36%) is associated with a 10% to 74% decrease in the risk of death and a 7% to 58% decrease in the risk of hospitalization compared with lower Hb (Hct) levels. These clinical data illustrate the importance of maintaining all dialysis patients at Hb levels > or = 11 g/dL and Hct levels > or = 33%. More recently, a series of publications have suggested that additional incremental improvements in mortality and morbidity rates may be realized when Hb and Hct levels are maintained above the target range recommended by the NKF-K/DOQI. While these results are intriguing, the safety and efficacy of this approach require further study and clarification.