Low hemoglobin levels are associated with worse survival and cardiovascular outcomes in patients with chronic kidney disease (CKD), according to a new study.

In an analysis of 9 prospective randomized controlled trials that enrolled a total of 3,405 CKD patients, Francesco Locatelli, MD, of Ospedale Alessandro Manzoni, Lecco, Italy, and colleagues found that an hemoglobin (Hb) level below 10 g/dL was associated with a significant 84% increased risk of a composite endpoint of all-cause mortality, cerebrovascular events (CVE), and myocardial infarction compared with a reference level of 10 or higher but less than 11. It also was associated with a significant 2.5 times increased risk of all-cause mortality.

In addition, the study, which was published online ahead of print in Nephron Clinical Practice, found that patients whose Hb level decreased by more than 1 g/dL from their target value (10–13 g/dL) had a significant 2.6 times, 2.9 times, and 2.6 times increased risk of the composite endpoint, all-cause mortality, and CVE, respectively, compared with patients who maintained their Hb level within 1 g/dL or less of their target value.

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