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During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
This study aimed to characterize the global longitudinal trends and local fluctuation patterns of hemoglobin levels in hemodialysis patients during treatment and to investigate the impact of hemoglobin change trajectories on the risk of cardiovascular events and mortality.
This retrospective cohort study included patients receiving hemodialysis at Zhongshan Hospital, Fudan University, Shanghai, China, between 2015 and 2025. Hemoglobin levels were longitudinally collected at multiple time points, and participants were prospectively followed for the occurrence of major adverse cardiovascular events (MACE) and all-cause mortality. Latent class growth modeling (LCGM) was used to identify distinct hemoglobin trajectory patterns, while variability independent of the mean (VIM) was calculated to quantify short-term fluctuations. The associations between hemoglobin trajectory patterns and the risks of MACE, mortality, and the composite endpoint were evaluated using multivariable Cox proportional hazards regression models.
A total of 699 patients were included in the study cohort. The mean age at enrollment was 57.5 years, and 63.8% were male. Three distinct hemoglobin trajectory patterns were identified: Trajectory 1 was characterized by persistently low hemoglobin levels (<100 g/L) throughout the observation period; Trajectory 2 exhibited an initial increase followed by a rapid decline; and Trajectory 3 showed relatively stable levels, with a mean range of 105-110 g/L. The overall VIM for hemoglobin fluctuations was 0.11%±0.05%. Univariate analysis revealed that advanced age, baseline anemia, inflammatory status, hyperkalemia, and other clinical factors were significantly associated with membership in Trajectory 2 and higher VIM values. The median follow-up duration was 5.6 years. During this period, MACE occurred in 252 patients (37.7%), and all-cause mortality in 178 patients (26.6%). Multivariable Cox regression analysis showed that Trajectory 2 was independently associated with increased risks of MACE (adjusted HR = 2.00, 95% CI: 1.16-3.46) and mortality (HR = 3.29, 95% CI: 1.66-6.51). Similarly, patients in the highest quartile of VIM (Q4) had significantly elevated risks of MACE (HR = 2.34, 95% CI: 1.58-3.48) and mortality (HR = 1.79, 95% CI: 1.13-2.84). In the additive model, the combination of Trajectory 2 and high VIM (Q4) conferred the greatest risk, with the highest incidence rates and hazard ratios for all outcomes.
The "first rise, then drop" hemoglobin trajectory and high-level fluctuations are independently associated with an increased risk of cardiovascular events and all-cause mortality in hemodialysis patients. These findings suggest that hemoglobin management should not be limited to achieving target levels at isolated time points, but should prioritize the long-term stability of hemoglobin concentrations to improve clinical outcomes.
