维持性血液透析患者主动脉瓣和二尖瓣钙化的危险因素

目的 探讨主动脉瓣和二尖瓣钙化发病的相关危险因素。 方法 对符合标准的维持性血液透析（MHD）患者（年龄≥18岁,透析龄>6个月,排除曾因瓣膜疾病行外科手术或介入治疗者）,采用超声心动图检查心脏瓣膜钙化情况。采用Logisitc回归分析主动脉瓣和二尖瓣钙化的危险因素。 结果 在入选的181例（男98例,女83例）MHD患者中,94例（51.9%）主动脉瓣或二尖瓣钙化,其中主动脉瓣钙化90例（49.7%）,二尖瓣钙化30例（16.6%）,主动脉瓣和二尖瓣双瓣膜钙化26例（14.4%）。多因素Logistic回归分析表明年龄（β = 5.52, P = 0.007）、透析龄（β = 6.99,P = 0.039）和前白蛋白（β = -12.616,P = 0.004）与主动脉瓣钙化独立相关;年龄（β = 0.085,P = 0.05）与二尖瓣钙化呈弱正相关;透析龄（β = 6.057,P = 0.002）、原发性高血压病病史（β = 3.054,P = 0.008）、血红蛋白（β = -0.061,P = 0.035）和β2微球蛋白（β = 7.63,P = 0.01）与二尖瓣钙化独立相关。 结论 MHD患者主动脉瓣及二尖瓣钙化多发,且以主动脉瓣钙化更多见。年龄、透析龄和低前白蛋白血症是主动脉瓣钙化的危险因素,而二尖瓣钙化的危险因素包括年龄、透析龄、原发性高血压病病史、贫血和高β2微球蛋白血症。     

维持性血液透析患者主动脉钙化相关影响因素分析

目的：探讨维持性血液透析（MHD）患者主动脉钙化的相关影响因素。方法：采用胸部正位X线成像技术检测183例MHD患者主动脉钙化情况,将入选患者分为主动脉钙化组（A组）和主动脉无钙化组（B组）,透析前抽血检测血钙、血磷、全段甲状旁腺激素（iPTH）、C反应蛋白（CRP）和血清白蛋白（Alb）等指标,并计算钙磷乘积,比较两组年龄、透析龄和血清学指标的差异,将上述指标与主动脉钙化进行相关性分析,并对筛选出来的危险因素进行非条件Logistic回归分析。结果：A组和B组在年龄、透析龄、血磷、钙磷乘积和CRP水平方面,差异均有统计学意义（P〈0.01或P〈0.05）;MHD患者主动脉钙化的相关影响因素包括：年龄、透析龄、血磷、钙磷乘积及CRP;Logistic回归分析表明,年龄、透析龄和血磷是主动脉钙化的独立危险因素（P〈0.01）。结论：MHD患者主动脉钙化相当常见,主动脉钙化与年龄、透析龄、钙磷代谢和炎症状态有关。     

尿毒症患者血管钙化研究新进展

心血管疾病(CVD)是终末期肾病(ESRD)患者的主要并发症。 心肌、瓣膜、血管壁的异位钙化是ESRD患者CVD的重要因素之一。近来临床和实验研究显示高磷、炎症、脂质代谢异常、氧化压力、E-选择素的多态性等多种因素与血管钙化有关。本文就尿毒症患者心血管钙化机制的最新认识作一综述。     

血液透析患者血管钙化、骨密度与骨保护素及其配体的相互关系

目的 研究维持性血液透析（MHD）患者血管钙化、骨密度与血清骨保护素（OPG）及其配体sRANKL的相互关系。 方法 采用酶联免疫吸附法测定血清OPG、sRANKL水平；X线平片检测腹主动脉、股动脉及桡动脉部位血管钙化，计算血管钙化积分；双能X线骨密度仪测定腰椎及股骨骨密度。对各参数的相互关系进行统计分析。 结果 （1）39例MHD患者中25例（64.1%）在不同部位有不同程度的血管钙化，其中轻度钙化16例（41.0%），中重度钙化9例（23.1%）。中重度钙化者血清OPG水平、OPG/sRANKL比值显著高于轻度钙化者[（342.50±171.53） ng/L比（206.21±137.88） ng/L，t = -2.253，P = 0.025；454.65±455.63比135.31±136.81，t = 59，P = 0.035]，而sRANKL水平差异无统计学意义[（0.10±0.08） pmol/L比(0.12±0.08) pmol/L，t = 0.534，P > 0.05]。多元线性回归分析显示 OPG/sRANKL是血管钙化评分的独立影响因素。（2）与骨量正常者比较，骨量异常者血清OPG水平升高[（249.05±137.66） ng/L比（226.67±170.12） ng/L]，sRANKL水平降低[（0.11±0.08） pmol/L比（0.12±0.02） pmol/L]，OPG/sRANKL比值升高（202.31±219.24比148.08±210.10），但差异均无统计学意义。多元线性回归分析显示OPG/sRANKL是腰椎T值的独立影响因素。（3）多元线性回归分析显示血管钙化评分是腰椎和股骨T值的独立影响因素。 结论 MHD患者血管钙化程度是腰椎及股骨骨密度的独立影响因素， OPG/sRANKL可能在血管钙化和骨密度的关系中起了纽带作用。     

终末期肾病患者血管钙化与钙化抑制物

终末期肾病患者普遍存在血管钙化,钙化是一个主动的调节过程,最近的研究认为钙化是促钙化因素与抑制钙化因素间不平衡的结果。本文就钙化抑制物及其与终末期肾病的关系作一综述。     

尿毒症患者血管钙化研究新进展

心血管疾病 (CVD)是终末期肾病 (ESRD)患者的主要并发症 ,心肌、瓣膜、血管壁的异位钙化是ESRD患者CVD的重要因素之一。近来临床和实验研究显示高磷、炎症、脂质代谢异常、氧化压力、E 选择素的多态性等多种因素与血管钙化有关。本文就尿毒症患者心血管钙化机制的最新认识作一综述。     

珠三角地区血液透析患者代谢性酸中毒与心脏瓣膜钙化的相关关系——多中心横断面研究

目的:探讨维持性血液透析（maintenance hemodialysis,MHD）患者代谢性酸中毒与心脏瓣膜钙化的相关关系。方法:选择2019年7月1日至9月30日在珠三角地区10家血液净化中心行MHD大于3个月的患者纳入该多中心横断面研究,应用心脏彩超检查分为非心脏瓣膜钙化组和心脏瓣膜钙化组,记录人口学特征、透析次...     

终末期肾脏病患者血管钙化的治疗进展

终末期肾脏病患者的血管钙化与心血管事件发生率及死亡率密切相关.近年随着对血管钙化病理生理机制的深入研究,针对血管钙化的治疗除积极研发新药纠正钙磷代谢紊乱及甲状旁腺功能亢进之外,维生素K、焦磷酸盐及硫代硫酸盐等直接干预血管钙化机制的方法也在积极探索中.甲状旁腺切除术作为药物治疗无效时的选择也有较高应用价值.本文就终末期肾脏病血管钙化的治疗进展作一综述.     

糖尿病合并代谢综合征患者冠状动脉钙化相关危险因素分析

目的探讨糖尿病合并代谢综合征患者冠状动脉钙化的相关危险因素。方法选择行冠状动脉CT检查的患者166例,包括糖尿病合并代谢综合征患者93例（DMS组）,单纯糖尿病患者40例（D组）,非糖尿病及代谢综合征患者33例（N组）。应用螺旋CT检查并计算冠状动脉钙化积分,同时记录患者的临床基本特征,检测空腹胰岛素、总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、C反应蛋白（CRP）等指标,并进行比较。结果DMS组患者TC、TG、LDL-C、CRP水平均高于N组,差异有统计学意义（P〈0.05或〈0.01）,体重指数、冠状动脉钙化积分显著高于D组及N组,差异有统计学意义（P〈0.05或〈0.01）。多元Logistic回归显示,年龄、糖尿病、TC、体重指数是冠状动脉钙化的独立危险因素。结论糖尿病合并代谢综合征增加了冠状动脉钙化水平,冠心病危险性明显增加。CRP不是冠状动脉钙化的独立危险因素。     

血管钙化的发病机制及防治

血管钙化是指发生于心血管系统软组织内的不适当的生物钙化,在终末期肾脏病患者中很常见.本文对其发病机制及防治进行综述.     

Relationship between abdominal aortic calcification and outcomes in maintenance hemodialysis patients

Objective To investigate the relationship between abdominal aortic calcification (AAC) and outcomes in maintenance hemodialysis (MHD) patients. Methods One hundred and seventy MHD patients in the dialysis center of the Second Hospital of Tianjin Medical University from June 2014 and October 2014 were enrolled prospectively. Abdominal aortic calcification (AAC) was measured using AAC score (AACS) by abdominal lateral plain radiography. According to the AACS, the patients were divided into mild AAC (AACS＜5) group and severe AAC (AACS≥5) group for comparison, and Kaplan-Meier analysis was used to compare their survival rates. Multivariable COX regression models were used to determine the risk factors of all - cause mortality and cardiovascular disease mortality in MHD patients. Results Severe AAC (AACS≥5) was present in 28.2% (48/170) patients. The median follow-up duration was 25.6 (22.0, 26.0) months. During the follow-up, 6 patients (4.9%) in AACS＜5 group and 14 patients (29.2%) in AACS≥5 group died. Kaplan-Meier analysis showed that patients in AACS≥5 group had higher all-cause mortality rate and cardiovascular disease mortality rate as compared with patients in AACS＜5 group (χ2=9.746,P=0.002; χ2=9.697,P=0.002). Multivariate COX regression analysis demonstrated that high AACS (HR=4.373, 95%CI 1.562-7.246, P=0.005) and hypoproteinemia (HR=0.886, 95% CI 0.797 - 0.985, P=0.025) were independent risk factors for all-cause mortality, while hypoproteinemia (HR=0.829, 95%CI 0.718-0.956, P=0.010) and low 1,25(OH)D3 (HR=0.769, 95% CI 0.627 - 0.944, P=0.012) were independent risk factors for cardiovascular disease mortality. Conclusions AAC is significantly associated with overall survival in MHD patients. To further evaluate the relationship between AAC and outcomes in MHD patients, multi-center and long term follow up studies of large sample size are necessary.     

Relationship between coronary artery calcification and outcomes in maintenance hemodialysis patients

Objective To evaluate the relationship between coronary artery calcification (CAC) and outcomes in maintenance hemodialysis (MHD) patients. Methods Eighty-six patients who were on MHD between October 2014 and May 2015 in the blood purification center of our hospital were enrolled prospectively. CAC was measured and scored by multiple slice computed tomography (MSCT). According to the CAC score (CACs), the patients were divided into mild CAC (CACs＜100) group and severe CAC (CACs≥100) group. Kaplan-Meier analysis was performed to analyze the survival rates of the two groups, and a COX proportional hazards regression model was used to estimate the risk factors of all-cause mortality and cardiovascular disease mortality in MHD patients. Results Severe CAC (CACs≥100) was present in 62.8% (54/86) patients. The median of follow-up duration was 28.9(23.8, 29.4) months. During the follow up, 2(6.3%) patients in CACs＜100 group and 18 (33.3%) patients in CACs≥100 group died. Kaplan-Meier survival analysis demonstrated that patients in CACs≥100 group had higher all-cause mortality and cardiovascular mortality as compared with patients in CACs＜100 group (P=0.007, P=0.030). Multivariate COX regression analysis demonstrated that CACs≥100 (HR=7.687, 95%CI 1.697-34.819, P=0.008) and low single-pool Kt/V (HR=0.092, 95%CI 0.020-0.421, P=0.002) were independent risk factors for all-cause mortality. Old age (HR=1.192, 95%CI 1.100-1.291, P＜0.001), short duration of dialysis (HR=0.598, 95%CI 0.445-0.804, P=0.001), low 25-hydroxy vitamin D3 (HR=0.461, 95%CI 0.326-0.630, P＜0.001), and low total cholesterol (HR=0.405, 95%CI 0.213-0.772, P=0.006) were independent risk factors for cardiovascular disease mortality. Conclusions The CACs is significantly related with overall survival in MHD patients. Large multicenter prospective studies are to be evaluated the association between CACs and long-term survival in MHD patients.     

Association of serum FGF23 with abdominal aortic calcification and outcomes in maintenance hemodialysis patients

Objective To explore the association of fibroblast growth factor-23 (FGF23) with abdominal aortic calcification(AAC) and adverse outcomes in maintenance hemodialysis patients. Methods One hundred and fourteen cases of MHD patients were collected prospectively. Serum intact FGF23 was detected by ELISA. Abdomen lateral plain was used as a criteria to determine the abdominal aortic calcification and the abdominal aortic calcification score was counted. Logistic regression analysis was used to determine the risk factors of AAC. Kaplan-Meier analysis was applied to compare the survival rate among different groups and COX regression analysis was used to determine the association of FGF23 and mortality in MHD patients. Results Seventy-six patients present abdominal aortic calcification. The median of AACS was 4.0(0.0, 11.0). The median level of FGF23 was 7277.4(2535.0, 9990.8) pg/ml. The median follow-up duration was 72.0(67.8, 72.8) months. During the follow-up, 22 patients (19.3%) died of all-cause death and 17 cases (14.9%) died of cardiovascular diseases. Serum FGF23 level was positively correlated with AAC (r=0.285, P=0.002). Logistic regression analysis showed that longer age (OR=1.059, 95%CI: 1.020-1.100, P=0.003) and dialysis vintage (OR=1.009, 95%CI 1.000-1.017, P=0.039), smoking history (OR=3.010, 95%CI 1.177-7.696, P=0.021) and higher FGF23 level(OR=2.831, 95%CI 1.010-7.937, P=0.048) were independent risk factors of moderate to severe AAC in MHD patients. Kaplan-Meier survival curves showed that the patients with AACS≥5 had significantly higher all-cause mortality(P=0.028) and CVD mortality (P=0.035) than those with AACS＜5. However, the Kaplan-Meier analysis showed no significant difference regarding the level of serum FGF23 with the all-cause and CVD mortality. Cox regression demonstrated that FGF23 was not associated with increased mortality risk, neither in crude nor in multivariate adjusted models. Conclusions Abdominal aortic calcification had a high prevalence in MHD patients. The all-cause and CVD mortality was higher in patients with moderate to severe AAC. FGF23 was an independent risk factor of moderate to severe AAC, but it can't yet be a predictor for the all-cause and CVD mortality of MHD patients.     

Relationship between serum magnesium level and coronary artery calcification in maintenance hemodialysis patients

Objective To evaluate the relationship between serum magnesium and coronary artery calcification (CAC) and their associated factors. Methods 131 patients with chronic kidney disease on regular hemodialysis (HD) were recruited into this study from December 2014 to December 2015 in our center. Demographic and clinical data of selected patients were collected. Serum fibroblast growth factor 23 (FGF-23) level was quantified by enzyme linked immunosorbent assay(ELISA). Quantification of coronary artery calcification score (CACs) was determined by multi-slice spiral computed tomography (MSCT). The relationships between serum magnesium and FGF-23 level, CACs, demographic and clinical data were investigated. Results Patients were divided into low serum magnesium group, normal serum magnesium group and high serum magnesium group according to their serum magnesium levels. There were significant differences in the distribution of diabetes history, serum phosphorus, serum albumin, serum pre albumin, serum uric acid among these three groups(P＜0.05). A significant positive correlation was confirmed between serum magnesium level and serum albumin, serum pre albumin, serum phosphorus and serum uric acid by Pearson correlation analysis and Spearman correlation analysis (r=0.389, 0.234, 0.200, 0.234, P=0.000, 0.007, 0.022, 0.007, respectively). According to the degree of CAC, all maintenance hemodialysis (MHD) patients were divided into non-calcification group, low calcification group, moderate calcification group and high calcification group, and there were significant differences in the distribution of the age, serum phosphorus, serum magnesium, FGF-23 levels among these groups (P＜0.05) . Spearman correlation analysis showed that CACs was positively correlated with age, FGF-23, serum phosphorus (r=0.309, 0.277, 0.180, P=0.000, 0.001, 0.040, respectively), while negatively correlated with serum magnesium level (r=-0.238, P=0.006) in patients with MHD. The independent risk factors of CACs were aging, high level of FGF-23 in MHD patients by using ordinal logistic regression. However, Hypermagnesemia was a protective factor. Conclusions The history of diabetes, low serum albumin, phosphorus metabolism disorder and CAC are associated with hypomagnesemia in MHD patients. In MHD patients, aging as well as high level of FGF-23 are the risk factors of CAC, and hypermagnesemia is a protective factor of CAC.     

甲状旁腺切除术后维持性血液透析患者腹主动脉钙化的改变

目的 观察维持性血液透析(maintenance hemodialysis,MHD)合并继发性甲状旁腺功能亢进(secondary hyperparathyroidism,SHPT)患者行甲状旁腺切除术(parathyroidectomy,PTX)后腹主动脉钙化及生化指标的发展变化.方法 回顾性分析完成2年随访的严重SHPT患者,按是否行PTX分成PTX手术组和非手术组,观察术后2年腹主动脉钙化评分(abdominal aortic calcification score,AACS)、血清全段甲状旁腺素(iPTH)、血钙、血磷等变化.PTX手术组按照术后2年腹主动脉钙化有无进展分为进展组和非进展组,对比两组的年龄、透析龄、iPTH、血钙、血磷、钙磷乘积等指标,分析腹主动脉钙化进展的相关因素.结果 共纳入44例MHD合并SHPT患者,PTX手术组26例,非手术组18例.PTX手术组与非手术组基线资料比较,透析龄差异有统计学意义(P<0.05),而性别、年龄、高血压史等差异均无统计学意义.与术前比较,PTX手术组患者术后2年血iPTH、血钙、血磷均降低(均P<0.05),AACS前后差异无统计学意义.患者术后2年有8例(30.77%)腹主动脉钙化加速进展,8例(30.77%)腹主动脉钙化好转,10例(38.46%)腹主动脉钙化稳定.患者术后2年腹主动脉钙化非进展组iPTH值低于进展组[(20.62+6.44) ng/L比(132.72±76.83) ng/L,P<0.05],而非进展组术前AACS高于进展组[(13.11±2.71)分比(2.00±1.41)分,P<0.05].非手术组患者2年后AACS高于基线水平[(10.44±1.65)分比(8.05±1.26)分,P<0.05],血磷及钙磷乘积显著下降(均P<0.05),iPTH、血钙等水平无明显变化(均P>0.05).Pearson相关分析结果显示,PTX手术组术后2年AACS相对于术前的下降值与iPTH下降值(r=0.534,P=0.012)、血钙下降值(r=0.643,P=0.004)、血磷下降值(r=0.897,P<0.001)、钙磷乘积的下降值(r=0.568,P=0.021)呈正相关,与术前AACS值呈负相关(r=-0.647,P=0.014).结论 小样本资料显示,相比非手术治疗,PTX可长期纠正甲状旁腺素、钙、磷代谢紊乱,并有阻止腹主动脉钙化进展甚至逆转血管钙化的可能,而腹主动脉钙化逆转可能与iPTH、血Ca、血P、钙磷乘积的下降程度相关.     

骨硬化蛋白与维持性血液透析患者冠状动脉钙化的关系

Objective To evaluate the potential association of serum sclerostin with the development of coronary artery calcifications(CAC)in maintenance hemodialysis (MHD) patients. Methods Ninety-two patients who were on MHD between Jan 2014 and Jan 2015 in the dialysis center were enrolled prospectively. Serum sclerostin was tested. CAC was measured by multi-slice computed tomography (MSCT) scanning, and the CAC score (CACs) was calculated. Logistic regression analysis was used to determine the risk factor of CAC in MHD patients. The diagnostic value of serum sclerostin for CAC was assessed using receiver operator characteristic curve (ROC). Results CAC (Agatston score>100) was present in 65.2% (60/92) patients, the median CAC score was 446 (26, 1 000). The median of serum sclerostin levels was 37.05 (29.99, 49.04) ng/L. The serum sclerostin levels were significantly elevated in the group of CACs＞400 compared to that in the group of CACs＜100 [40.71(36.69, 74.21) ng/L vs 28.16 (25.27, 33.64) ng/L, P＜0.05]. Multivariate logistic regression analysis showed that serum sclerostin level was independent risk factor for CAC (OR=1.292, 95%CI 1.017-1.641, P＜0.05). The area under the ROC curve (AUC) of serum sclerostin for CAC was 0.846 (95%CI 0.717-0.975, P=0.001), sensitivity was 0.826, and specificity was 0.769 for a cutoff value of 35.165 ng/L. Conclusions Serum sclerostin level is associated with CAC. Serum sclerostin level may have a diagnostic value for CAC in MHD patients.     

维持性血液透析患者血清脂联素与动脉粥样硬化的相关性分析

目的探讨维持性血液透析患者血清脂联素水平与动脉粥样硬化的相关性。方法将30例维持性血液透析患者设为透析组,10名相匹配的健康体检者设为对照组,测定血清脂联素水平,同时测定相应的生化指标及颈总动脉内膜中层厚度,并根据颈动脉内膜厚度,将维持性血液透析患者分为颈动脉正常组和颈动脉硬化组。结果维持性血液透析患者血清脂联素水平明显高于对照组（P〈0．05）,与颈动脉内膜中层厚度呈显著负相关（r=－0．378,P〈0．05）;而颈动脉硬化组血清脂联素水平低于颈动脉正常组（P〈0．05）。结论维持性血液透析患者血清脂联素明显高于正常人,其浓度与动脉硬化程度呈负相关,对其更深一步的研究有助于对维持性血液透析患者动脉硬化的发生提供更好、更敏感的检测方法。     

Effects of abdominal aortic calcification progression on outcomes in maintenance hemodialysis patients

Objective To investigate the effects of abdominal aortic calcification (AAC) progression on outcomes in maintenance hemodialysis (MHD) patients. Methods Patients who were on MHD between Jun. 2014 and Oct. 2014 in the dialysis center of the Second Hospital of Tianjin Medical University and finished the AAC examination at baseline and two years later were included prospectively. The progression of AAC by AAC score (AACs) at baseline and two years later was evaluated. According to the change of AACs, the patients were divided into rapid AAC progression group and non-rapid AAC progression group. The effect of AAC progression on outcomes in MHD patients in the follow-up period was investigated. Kaplan-Meier analysis was used to compare their survival rates. Multivariable Cox regression model was used to determine the risk factors of all-cause mortality, cardiovascular mortality and cardiovascular events. Results A total of 111 MHD patients were included, including 51 males and 60 females, aged (52.24±12.69) years. Baseline AAC prevalence was 45.9% (51/111), and median AACs was 0 (0, 5); After 2 years, the prevalence of AAC was 78.4% (87/111), and the median AACs was 6 (2, 11). There were 54 cases in the AAC rapid progression group (AACs change value＞2) and 57 cases in the non-rapid AAC progression group (AACs change value≤2). The median follow-up duration was 27.9(27.1, 28.0) months. Kaplan-Meier analysis showed that patients in rapid AAC progression group had a higher risk of mortality as compared to patients in non-rapid AAC progression group (Log-rank χ2=5.695, P=0.017). Multivariate Cox regression analysis demonstrated that high baseline AACs (HR=1.135, 95%CI 1.001-1.286, P=0.048), hypoalbuminemia (HR=0.789, 95%CI 0.640-0.972, P=0.026) were independent risk factors for all-cause mortality in MHD patients. High baseline AACs (HR=1.187, 95%CI 1.038-1.356, P=0.012), low spKt/V (HR=0.103, 95%CI 0.013-0.801, P=0.030) were independent risk factors for cardiovascular mortality in MHD patients. Low spKt/V (HR=0.018, 95%CI 0.003-0.115, P＜0.001), hypoalbuminemia (HR=0.736, 95%CI 0.608-0.890, P=0.002) were independent risk factors for cardiovascular events in MHD patients. Conclusions Abdominal aortic calcification progression may increase the risk of cardiovascular events and death in MHD patients. Severity of AAC, adequacy of dialysis, and nutritional status are predictors of outcomes in MHD patients.     

Relationship between anemia and clinic outcomes in maintenance hemodialysis patients

Objective To analysis the relationship between anemia and clinic outcomes retrospectively in maintenance hemodialysis patients for Renji Hospital, Shanghai Jiao Tong University School of Medicine, China. Methods This study enrolled all maintenance hemodialysis（MHD）patients between 1 January, 2007 and 31 December, 2014 at the Renji Hospital. They were followed up until death, cessation of hemodialysis, transfer to other centers or to the end of the study (31 December, 2014). Laboratory parameters, including hemoglobin concentrations, transferrin saturation, ferritin, serum albumin, were measured every 3 months. According to the Kidney Disease Outcomes Quality Initiative (K/DOQI) guidelines, the patients were divided into target-hemoglobin group (110≤Hb ≤120 g/L) and non target-hemoglobin group ( 120 g/L), and then the compliance rate of Hb, Ferritin, transferrin saturation, and the influence factors of compliance rate of Hb as well as its relationship with the prognosis were analyzed. Results Total 517 maintenance hemodialysis patients were involved in this study. The mean age was (63.76±14.78) years and 59.96% patients were male. Only 35.20%, 91.26% and 31.18% of them met the K/DOQI defined targets for hemoglobin, transferrin saturation and ferritin levels. The average levels of TSAT and Ferritin had no significant difference between the target-hemoglobin group and the non target-hemoglobin group. Compared with patients in non target-hemoglobin group, the target-hemoglobin group had significantly higher qualified rate of transferrin saturation (94.97% vs 89.41%, P=0.045) and Ferritin (37.22% vs 28.13%, P=0.036). Multivariate logistic regression analysis showed that the serum albumin, blood intact parathyroid hormone (iPTH) and dialysis vintage were independent risk factors that affected whether hemoglobin was up to the target. Kaplan-Meier analysis showed that the 8-year survival rate and cardiovascular survival rate in target-hemoglobin group were obviously higher than that in the non target-hemoglobin group (86.70% vs 75.30%, χ2Log rank=7.134, P=0.008; 93.80% vs 85.30%, χ2Log rank=6.134, P=0.013, respectively). Dialysis frequency, age and ferritin were independent risk factors of all-cause mortality for non target-hemoglobin group, and Dialysis frequency was independent risk factors of cardio-cerebral vascular disease mortality for non target-hemoglobin group. Conclusions The compliance rate of hemoglobin in MHD patients is still not steady controlled. Blood iPTH, serum albumin and dialysis vintage are independent risk factors that affect whether hemoglobin is up to the target in MHD patients. Sub-standard hemoglobin increases both all-cause mortality and cardio-cerebral vascular disease mortality in MHD patients.