Association of increased travel distance to dialysis units with the risk of anemia in rural chronic hemodialysis elderly
Journal
Hemodialysis International
Journal Volume
19
Journal Issue
1
Pages
44-53
Date Issued
2015
Author(s)
Abstract
Geographic remoteness has been found to influence health-related outcomes negatively. As reported in the literature, rural dialysis patients have a higher risk of mortality with increasing travel distance to dialysis units. However, few studies have focused on the impact of travel distances on the development of dialysis complications. We utilized a prospectively collected chronic hemodialysis patient cohort from a rural regional hospital for analysis. Data on demographics, comorbidities, and serum laboratory results were obtained. Correlation analyses between travel distance to dialysis units and dialysis complications were conducted, and significantly correlated parameters were entered into multivariate logistic regression models to determine their exact associations. A total of 46 rural chronic hemodialysis patients were enrolled, with an average age higher than others in the literature. Significant correlation was found between travel distance and serum hemoglobin levels (R2=-0.34, P value=0.029). Multivariate logistic regression found that every 1km increase in travel distance was associated with an increased risk of anemia (hemoglobin <9g/dL) (odds ratio 1.46; P value=0.01). Sensitivity analyses further showed that the associated risk was partially attenuated by serum albumin (odds ratio 1.83; P value=0.07) and ferritin (odds ratio 1.39; P value=0.08) levels. This is the first study to demonstrate the association between increased travel distance to dialysis units and the risk of anemia in chronic dialysis patients, especially elderly. Malnutrition, inflammation, and atherosclerosis syndrome could be partially responsible for the observed association. Further research is required to confirm our findings. ? 2014 International Society for Hemodialysis.
SDGs
Other Subjects
albumin; erythropoietin; erythropoietin beta; ferritin; iron saccharate; unclassified drug; aged; anemia; Article; atherosclerosis; clinical article; end stage renal disease; female; geriatric patient; hemodialysis; hemoglobin blood level; hospital; human; inflammation; laboratory test; male; malnutrition; risk factor; rural area; travel; adverse effects; anemia; renal replacement therapy; rural population; time; Aged; Anemia; Female; Humans; Male; Renal Dialysis; Risk Factors; Rural Population; Time Factors; Travel
Publisher
Blackwell Publishing Inc.
Type
journal article