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논문분류	춘계학술대회 초록집
제목	Dose anemia is associated with ESKD progression and mortality? : Study from multinational cohort
저자	Soie Kwon
출판정보	2024; 2024(1):
키워드
초록	Objectives: Anemia is prevalent in patients with chronic kidney disease (CKD), leading not only to disabling symptoms but also potentially accelerating CKD progression or increasing mortality in non-dialysis patients. We reaffirmed this through cohorts in two countries and analyzed whether the same hypothesis holds when considering changes in hemoglobin levels during the follow-up period. Methods: We performed a retrospective cohort study from two hospitals in South Korea and one hospital in Taiwan. The anemic patients were defined as patients with an initial hemoglobin level of <10 mg/dL. To consider changes of serum hemoglobin level after enrollment, time-varying Cox analysis was used. Results: Among 21,225 patients, 5,384 patients were grouped as anemic patients at the enrollment. The median estimated Glomerular Filtration Rate (eGFR) was lower in anemic patients as 18.7 [IQR 10.4; 30.6] mL/min/1.73m^2 than non-anemic patients as 36.8 [25.3; 46.7]. Also, anemic patients has more comorbidities than non-anemic patients (Table 1). As CKD stages progressed, the average hemoglobin level increased, with a notable decrease in hemoglobin levels among Taiwanese patients, especially in CKD stages 4-5. In time-fixed analysis with full adjustment, higher hemoglobin level is associated with lower risk of end-stage kidney disease (ESKD) progression (aHR 0.93, 95% CI 0.919‒0.951, p-value <0.001) and all-cause mortality (aHR 0.90, 95% CI 0.889‒0.914, p-value <0.001). The trend was persistent even after time-varying consideration of serum hemoglobin level (ESKD: aHR 0.65, 95% CI 0.630‒0.663, p-value <0.001; all-cause mortality: aHR 0.81, 95% CI 0.802‒0.823, p-value <0.001) Conclusions: We reaffirmed the risk associated with the occurrence of anemia. Also, as differences in ESA usage practices between Korea and Taiwan, future analyses will consider these variations to determine if ESA usage is associated with reductions in anemia and improvements in renal outcomes and other hard outcomes such as mortality.
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