Anaemia, plasma volume and haemoglobin mass in dialysis patients
Research type
Research Study
Full title
Study of Anaemia, Plasma volume and Haemoglobin mass in Renal Dialysis Patients’ (SAPHeR Dialysis)
IRAS ID
271773
Contact name
Andrew Davenport
Contact email
Sponsor organisation
Royal Free Hospital
Duration of Study in the UK
0 years, 3 months, 0 days
Research summary
Haemoglobin (Hb) is the blood’s oxygen carrying pigment, and is contained within red blood cells (RBCs). Anaemia is defined as a reduction in Hb concentration ([Hb]) to below 130gL-1 in men and 120gL-1 in non-pregnant women. It results from a fall in the number of RBCs that carry it, and/or the concentration of Hb within RBCs.
Anaemia is a common feature of chronic kidney disease (CKD) and is associated with adverse patient outcomes: increased morbidity and mortality, increased risk of hospitalisation, and greater hospital length of stay. Drugs to stimulate RBC production are prescribed to many such patients, at substantial cost.
Meanwhile, the fluid accumulation and expansion of the plasma volume (PV) that occurs in CKD is also associated with vastly increased risk of death but it is not possible to routinely measure PV in clinical practice.
Finally, ‘anaemia’ is defined as a concentration which is dependent on the circulating total mass of Hb (tHb-mass) and the PV in which it is contained. Since PV fluctuates in CKD, ‘anaemia’ may be diagnosed without any actual change in tHb-mass.
Therefore, whilst vast amounts of money and resource are spent on managing both anaemia and fluid status (through medication and dialysis), both suffer from inaccurate measurement techniques, resulting in potential harm to patients and unnecessary healthcare costs.
We propose to study the relative contributions of PV and tHb-mass to measured [Hb] in CKD by employing an accurate bedside measurement technique that is easy to use and inexpensive, and could be employed widely in the NHS. Proving the importance of accurate PV and tHb-mass measurement in this patient group will potentially lead to improved patient outcomes and decreased healthcare costs.
We propose to study 85 patients undergoing dialysis at Royal Free NHS Trust over a 3 month period, with each participant undergoing a single assessment.
REC name
London - Surrey Research Ethics Committee
REC reference
23/LO/0522
Date of REC Opinion
18 Aug 2023
REC opinion
Further Information Favourable Opinion