Association of anemia with outcomes in men with moderate and severe chronic kidney disease
Anemia is a common complication of chronic kidney disease (CKD), but the outcomes associated with lower hemoglobin (Hgb) levels in patients with CKD not yet on dialysis are not well characterized. Analyses exploring outcomes associated with a single baseline Hgb value also do not account for the lon...
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| Veröffentlicht in: | Kidney international 2006-02, Vol.69 (3), p.560-564 |
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| creator | Kovesdy, C.P. Trivedi, B.K. Kalantar-Zadeh, K. Anderson, J.E. |
| description | Anemia is a common complication of chronic kidney disease (CKD), but the outcomes associated with lower hemoglobin (Hgb) levels in patients with CKD not yet on dialysis are not well characterized. Analyses exploring outcomes associated with a single baseline Hgb value also do not account for the longitudinal variation of this measure. After collecting all Hgb measurements (N=17 194, median (range): 12 (1–168)) over a median follow-up period of 2.1 years in a historical prospective cohort of 853 male US veterans with CKD Stages 3–5 not yet on dialysis, we examined the association of time-averaged Hgb levels with predialysis all-cause mortality, end-stage renal disease (ESRD), and a composite end point of both. Kaplan–Meier survival analysis and Cox models adjusted for age, race, body mass index, smoking status, blood pressure, diabetes mellitus, cardiovascular disease, categories of estimated glomerular filtration rate, serum concentrations of albumin and cholesterol, and proteinuria were examined. Lower time-averaged Hgb was associated with significantly higher hazard of the composite end point (hazard ratio (95% confidence interval) in the adjusted model for time-averaged Hgb of 130 g/l: 2.57 (1.85–3.58), 1.97 (1.45–2.66), 1.19 (0.86–1.63), Ptrend |
| doi_str_mv | 10.1038/sj.ki.5000105 |
| format | Article |
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Analyses exploring outcomes associated with a single baseline Hgb value also do not account for the longitudinal variation of this measure. After collecting all Hgb measurements (N=17 194, median (range): 12 (1–168)) over a median follow-up period of 2.1 years in a historical prospective cohort of 853 male US veterans with CKD Stages 3–5 not yet on dialysis, we examined the association of time-averaged Hgb levels with predialysis all-cause mortality, end-stage renal disease (ESRD), and a composite end point of both. Kaplan–Meier survival analysis and Cox models adjusted for age, race, body mass index, smoking status, blood pressure, diabetes mellitus, cardiovascular disease, categories of estimated glomerular filtration rate, serum concentrations of albumin and cholesterol, and proteinuria were examined. Lower time-averaged Hgb was associated with significantly higher hazard of the composite end point (hazard ratio (95% confidence interval) in the adjusted model for time-averaged Hgb of <110, 111–120 and 121–130, compared to >130 g/l: 2.57 (1.85–3.58), 1.97 (1.45–2.66), 1.19 (0.86–1.63), Ptrend<0.001). Lower time-averaged Hgb was associated with both significantly higher pre-dialysis mortality and higher risk of ESRD, when analyzed separately. Anemia (especially time-averaged Hgb <120 g/l) is associated with both higher mortality and increased risk of ESRD in male patients with CKD not yet on dialysis.</description><identifier>ISSN: 0085-2538</identifier><identifier>EISSN: 1523-1755</identifier><identifier>DOI: 10.1038/sj.ki.5000105</identifier><identifier>PMID: 16395253</identifier><identifier>CODEN: KDYIA5</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Aged ; anemia ; Anemia - blood ; Anemia - complications ; Anemia - physiopathology ; Anemias. Hemoglobinopathies ; Biological and medical sciences ; Chronic Disease ; chronic kidney disease ; Cohort Studies ; Diseases of red blood cells ; end-stage renal disease ; Follow-Up Studies ; Hematologic and hematopoietic diseases ; Hemoglobins - analysis ; Humans ; Kidney Diseases - blood ; Kidney Diseases - complications ; Kidney Diseases - mortality ; Kidney Diseases - physiopathology ; Kidney Failure, Chronic - blood ; Kidney Failure, Chronic - epidemiology ; Kidney Failure, Chronic - etiology ; Kidney Failure, Chronic - physiopathology ; Kidneys ; Male ; Medical sciences ; Middle Aged ; mortality ; Nephrology. Urinary tract diseases ; Proportional Hazards Models ; Prospective Studies ; Risk Factors ; Severity of Illness Index ; Survival Analysis ; Urinary system involvement in other diseases. 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Analyses exploring outcomes associated with a single baseline Hgb value also do not account for the longitudinal variation of this measure. After collecting all Hgb measurements (N=17 194, median (range): 12 (1–168)) over a median follow-up period of 2.1 years in a historical prospective cohort of 853 male US veterans with CKD Stages 3–5 not yet on dialysis, we examined the association of time-averaged Hgb levels with predialysis all-cause mortality, end-stage renal disease (ESRD), and a composite end point of both. Kaplan–Meier survival analysis and Cox models adjusted for age, race, body mass index, smoking status, blood pressure, diabetes mellitus, cardiovascular disease, categories of estimated glomerular filtration rate, serum concentrations of albumin and cholesterol, and proteinuria were examined. Lower time-averaged Hgb was associated with significantly higher hazard of the composite end point (hazard ratio (95% confidence interval) in the adjusted model for time-averaged Hgb of <110, 111–120 and 121–130, compared to >130 g/l: 2.57 (1.85–3.58), 1.97 (1.45–2.66), 1.19 (0.86–1.63), Ptrend<0.001). Lower time-averaged Hgb was associated with both significantly higher pre-dialysis mortality and higher risk of ESRD, when analyzed separately. Anemia (especially time-averaged Hgb <120 g/l) is associated with both higher mortality and increased risk of ESRD in male patients with CKD not yet on dialysis.</description><subject>Aged</subject><subject>anemia</subject><subject>Anemia - blood</subject><subject>Anemia - complications</subject><subject>Anemia - physiopathology</subject><subject>Anemias. Hemoglobinopathies</subject><subject>Biological and medical sciences</subject><subject>Chronic Disease</subject><subject>chronic kidney disease</subject><subject>Cohort Studies</subject><subject>Diseases of red blood cells</subject><subject>end-stage renal disease</subject><subject>Follow-Up Studies</subject><subject>Hematologic and hematopoietic diseases</subject><subject>Hemoglobins - analysis</subject><subject>Humans</subject><subject>Kidney Diseases - blood</subject><subject>Kidney Diseases - complications</subject><subject>Kidney Diseases - mortality</subject><subject>Kidney Diseases - physiopathology</subject><subject>Kidney Failure, Chronic - blood</subject><subject>Kidney Failure, Chronic - epidemiology</subject><subject>Kidney Failure, Chronic - etiology</subject><subject>Kidney Failure, Chronic - physiopathology</subject><subject>Kidneys</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>mortality</subject><subject>Nephrology. Urinary tract diseases</subject><subject>Proportional Hazards Models</subject><subject>Prospective Studies</subject><subject>Risk Factors</subject><subject>Severity of Illness Index</subject><subject>Survival Analysis</subject><subject>Urinary system involvement in other diseases. 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Hemoglobinopathies</topic><topic>Biological and medical sciences</topic><topic>Chronic Disease</topic><topic>chronic kidney disease</topic><topic>Cohort Studies</topic><topic>Diseases of red blood cells</topic><topic>end-stage renal disease</topic><topic>Follow-Up Studies</topic><topic>Hematologic and hematopoietic diseases</topic><topic>Hemoglobins - analysis</topic><topic>Humans</topic><topic>Kidney Diseases - blood</topic><topic>Kidney Diseases - complications</topic><topic>Kidney Diseases - mortality</topic><topic>Kidney Diseases - physiopathology</topic><topic>Kidney Failure, Chronic - blood</topic><topic>Kidney Failure, Chronic - epidemiology</topic><topic>Kidney Failure, Chronic - etiology</topic><topic>Kidney Failure, Chronic - physiopathology</topic><topic>Kidneys</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>mortality</topic><topic>Nephrology. 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Analyses exploring outcomes associated with a single baseline Hgb value also do not account for the longitudinal variation of this measure. After collecting all Hgb measurements (N=17 194, median (range): 12 (1–168)) over a median follow-up period of 2.1 years in a historical prospective cohort of 853 male US veterans with CKD Stages 3–5 not yet on dialysis, we examined the association of time-averaged Hgb levels with predialysis all-cause mortality, end-stage renal disease (ESRD), and a composite end point of both. Kaplan–Meier survival analysis and Cox models adjusted for age, race, body mass index, smoking status, blood pressure, diabetes mellitus, cardiovascular disease, categories of estimated glomerular filtration rate, serum concentrations of albumin and cholesterol, and proteinuria were examined. Lower time-averaged Hgb was associated with significantly higher hazard of the composite end point (hazard ratio (95% confidence interval) in the adjusted model for time-averaged Hgb of <110, 111–120 and 121–130, compared to >130 g/l: 2.57 (1.85–3.58), 1.97 (1.45–2.66), 1.19 (0.86–1.63), Ptrend<0.001). Lower time-averaged Hgb was associated with both significantly higher pre-dialysis mortality and higher risk of ESRD, when analyzed separately. Anemia (especially time-averaged Hgb <120 g/l) is associated with both higher mortality and increased risk of ESRD in male patients with CKD not yet on dialysis.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>16395253</pmid><doi>10.1038/sj.ki.5000105</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged anemia Anemia - blood Anemia - complications Anemia - physiopathology Anemias. Hemoglobinopathies Biological and medical sciences Chronic Disease chronic kidney disease Cohort Studies Diseases of red blood cells end-stage renal disease Follow-Up Studies Hematologic and hematopoietic diseases Hemoglobins - analysis Humans Kidney Diseases - blood Kidney Diseases - complications Kidney Diseases - mortality Kidney Diseases - physiopathology Kidney Failure, Chronic - blood Kidney Failure, Chronic - epidemiology Kidney Failure, Chronic - etiology Kidney Failure, Chronic - physiopathology Kidneys Male Medical sciences Middle Aged mortality Nephrology. Urinary tract diseases Proportional Hazards Models Prospective Studies Risk Factors Severity of Illness Index Survival Analysis Urinary system involvement in other diseases. Miscellaneous |
| title | Association of anemia with outcomes in men with moderate and severe chronic kidney disease |
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