To investigate the prevalence and treatment of anemia in maintenance hemodialysis (MHD) patients in Shanxi Province, and to study the influencing factors.

Clinical data of MHD patients reported online in Shanxi Province in 2017 were collected through the National Blood Purification Registration System, including basic data, dialysis status, drugs treatment, and laboratory indicators. Hemoglobin (Hb) ≥110 g/L was taken as the goal of treatment. The data collected were then sorted out and analyzed.

In 2017, the average Hb level of MHD patients in Shanxi Province was (107.2±19.2) g/L, and 45.7% patients reached the goal level. The utilization rate of erythropoiesis stimulating agents (ESAs) was 97.6%. The utilization rate of iron agent was 35.5%, of which 68.0% was intravenous use. The gender stratification showed that male patients had a higher percentage in meeting the Hb goal than females. Age stratification showed that with the increase of age, the Hb goal rate had an increasing trend. Compared with the Hb<110 g/L group, the Hb≥110 g/L group had more male patients, higher average age, higher dialysis age, more use of import dialyser, higher urea reduction rate and higher clearance rate, more use of intravenous iron, more use of L-carnitine, higher HCO₃^- level, higher albumin level, and higher triglycerides level (all P<0.05). Compared with the Hb<110 g/L group, the Hb≥110 g/L group, however, had less patients with hypertension as primary disease, lower dose of ESA, less patients with transferrin saturation ≤30%, and lower levels of parathyroid hormone and C-reactive protein (all P<0.05). The multi-factor logistic regression analysis showed that male gender, intravenous iron use, and high level of albumin were the protective factors for the Hb goal, while parathyroid hormone and C-reactive protein were the risk factors.

The overall rate of Hb≥110 g/L in the MHD patients of Shanxi Province was 45.7%. Male gender, intravenous iron use, and high level of serum albumin may be protective factors, while parathyroid hormone and C-reactive protein may be the risk factors. Rational use of intravenous iron agents, improvement of nutritional status, and reduction of inflammatory reactions may improve the Hb level of the patients.