From the Guidelines
Significant hemoglobin (Hb) and hematocrit (Hct) values are those that indicate anemia or polycythemia, with Hb below 11 g/dL (Hct 33%) and above 12 g/dL (Hct 36%) being critical thresholds for adults, as evidenced by studies such as 1.
Key Points:
- For adults, hemoglobin levels below 11 g/dL (Hct 33%) are associated with increased morbidity and mortality, while levels above 12 g/dL (Hct 36%) are generally considered adequate 1.
- The target range for hemoglobin (hematocrit) should be Hgb 11 g/dL (33%) to Hgb 12 g/dL (36%), as recommended by clinical practice guidelines for anemia in chronic kidney disease 1.
- Hemoglobin levels below 10 g/dL (Hct 30%) are associated with worse patient outcomes, including increased risk of left ventricular hypertrophy, decreased quality of life, and higher mortality rates 1.
- Anemia is a significant factor in various conditions, including heart failure, renal failure, and malignancy, and its diagnosis and treatment are crucial for improving patient outcomes 1.
- Hemoglobin and hematocrit values vary by age, sex, and clinical context, and must be interpreted in light of these factors to ensure accurate diagnosis and treatment of anemia or polycythemia 1.
From the Research
Hemoglobin (Hb) Values
- The World Health Organization (WHO) defines anemia as Hb levels <12.0 g/dL in women and <13.0 g/dL in men 2, 3
- New lower limits of normal Hb values have been proposed, according to ethnicity, gender, and age 2
- Hb levels <12 g/dL in both sexes are considered anemic in the elderly population 2
- Hb concentrations <13 g/dL for men and <12 g/dL for women are defined as pernicious anemia (PA) by the WHO 3
- Normal Hb values for healthy persons living at high altitude (4000 meters) are:
- Men: 13-21 g/dL
- Women: 12-19 g/dL 4
- Hb levels between 4 gm% and 11 gm% are considered severe anemia in patients with menorrhagia 5
- An Hb level of 12-13 g/dL may be appropriate for some chronic kidney disease patients, depending on the individual patient and ESA dose 6