ANEMIA MANAGEMENT IN CHRONIC HEMODIALYSIS PATIENTS AT HIGH ALTITUDE

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Abstract Title

First Name *

Silvestre

Last Name *

Arze

Co-author 1

Daniella Sapiencia dsapiencia.s@gmail.com Nefrodial-Centro del Rinon Hemodialysis Cochabamba

Co-author 2

Jeydi Encinas rsarze@albatros.cnb.net Nefrodial-Centro del Rinon Hemodialysis Cochabamba

Co-author 3

Gimena Cadiz rsarze@albatros.cnb.net Nefrodial - Centro del Rinon Hemodialysis Cochabamba

Co-author 4

Gabriela Martinez rsarze@albatros.cnb.net Nefrodial - Centro del Rinon Hemodialysis Cochabamba

Co-author 5

Jennifer Bueno rsarze@albatros.cnb.net Nefrodial - Centro del Rinon Hemodialysis Cochabamba

Co-author 6

Co-author 7

Co-author 8

Co-author 9

Co-author 10

Co-author 11

Co-author 12

Co-author 13

Co-author 14

Co-author 15

Introduction

Bolivia is a less developed country, with marked geographical differences. Normal Hb levels increase in high altitude and uncontrolled anemia in chronic HD patients is an important cause of morbidity.

Methods

We describe the results of anemia management at a moderate high altitude, 2500 meters above sea level, (mean Hb 13 gr/l) in a retrospective and cross-sectional study to july 2023.

Results

From january 2015 to july 2023 we treated 51 patients aged 17 to 78 years. Women 63%. Etiology: diabetic 43%, hypertensive 24%, unknown 20%, glomerular 6%, other 8%. All in conventional HD for 3 to 114 months, water treated by reverse osmosis and 3 weekly sessions for 4 hours. No infections or recent blood transfusion. Minimal associated comorbidity. Dry weight 36 to 90 kg. Hb 13.1 g/l. Ferritin 732.8 mg/dl. % Transferrin saturation 26.2% . Treatment with SC erythropoietin alfa at a weekly dose in the last month of 2787 IU and IV iron sucrose at a total dose in the last month of 74.5 mg.

Conclusions

With individualized treatment based on the associated comorbidity and body weight, adequately treated water, optimal dose of dialysis, SC erythropoietin alfa and IV iron sucrose, the correction of anemia is satisfactory at our altitude, but should be more strict in places such as La Paz, El Alto, Oruro and Potosí located at 4000 meters above sea level (mean Hb 18 gr/l).

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