WASHINGTON—Patients with end-stage renal disease who have a rapid decline in residual kidney function (RKF) during their first year on hemodialysis (HD) are at increased risk of anemia, data presented at the American Society of Nephrology’s Kidney Week 2019 meeting.
In a study of 5403 incident HD patients, those with an annual decrease in residual renal urea clearance (KRU) of 3 mL/min/1.73 m2 or greater had more than twice the odds of anemia development compared with those who had no change or had an increase in KRU after adjusting for potential confounders, a team led by Kamyar Kalantar-Zadeh, MD, MPH, PhD, of the University of California Irvine School of Medicine, reported in a poster presentation. Patients with annual decline in urine volume of 600 mL/day or more had approximately 1.5 times greater odds of anemia compared with those who had no change or an increase in urine volume.
Overall, the study population had a median annual decline in KRU of 1.2 mL/min/1.73 m2.
“Preservation of RKF should be encouraged to improve outcomes among incident HD patients,” the authors concluded.
With regard to study limitations, Dr Kalantar-Zadeh and his colleagues noted that they did not have information available on medication use and specific markers of inflammation. They also acknowledged that selection bias may exist because with limited or no RKF are less likely to have undergone urine collections.
Kimura H, Ikuda Y, Rhee C, et al. A rapid decline of residual kidney function and anemia in incident hemodialysis patients. Presented at the American Society of Nephrology’s Kidney Week 2019 meeting held November 5 to 10 in Washington, DC. Poster SA-PO