Leukopenia or
thrombocytopenia is sometimes observed in
end-stage renal disease (
ESRD) patients, but the association between chronic
leukopenia or
thrombocytopenia and
hemodialysis (HD) is still unclear. We aimed to investigate the incidence of chronic
leukopenia or
thrombocytopenia in patients with
ESRD who received HD and to determine the risk factors of this complication. We retrospectively analyzed
ESRD patients treated with HD at Ditmanson Medical Foundation Chia-Yi Christian Hospital in 2018. The risk factors for the occurrence of chronic
leukopenia and
thrombocytopenia were analyzed by Cox regression models. Of the 473 patients in our study cohort, 46 (9.7%) patients had a hematologic abnormality, including 18 patients with chronic
leukopenia, 18 with chronic
thrombocytopenia, and 10 with
pancytopenia. Multivariate analysis revealed that patient age ≥60 years at the initiation of dialysis was a significant predictor for both chronic
leukopenia [adjusted hazard ratio (aHR), 2.71; 95% confidence interval (CI), 1.06-6.89] and chronic
thrombocytopenia (aHR, 2.83; 95% CI, 1.08-7.35). Chronic
liver disease (aHR, 3.31; 95% CI, 1.27-8.61) and serum
ferritin levels >800 mg/dl (aHR, 3.29; 95% CI, 1.29-8.39) were risk factors for chronic
thrombocytopenia. A trend showed that
vitamin D from intravenous supplementation (aHR, 0.13; 95% CI, 0.01-1.16, P = 0.066) and serum phosphorous level (aHR, 0.73; 95% CI, 0.53-1.02, P = 0.068) may be associated with chronic
thrombocytopenia. Our study demonstrated that hematological abnormality was a long-term complication of HD. These results reveal that older patients with HD and high serum
ferritin levels are at an elevated risk for chronic
cytopenia. Healthcare professionals should be aware of this risk when treating HD patients in order to improve their prognosis.