Anemia Hikes Long-Term Mortality in Non-Diabetic CKD Patients
This article is part of our ongoing coverage of Renal Week 2009. Click here for a complete list of our Renal Week Live articles.
- Anemia in non-diabetic CKD patients increases their risk of long-term mortality.
- This is predominantly explained by the association between anemia and degree of renal function.
- Compared with non-anemic patients, those with anemia had a 35% and 46% increased risk of all-cause and cardiovascular mortality, respectively, in unadjusted analyses.
Anemia in non-diabetic CKD patients increases their risk of long-term mortality, and this is predominantly explained by the association between anemia and degree of renal function, according to a study presented at ASN's Renal Week 2009.
Vandana Menon, MD, PhD, of Tufts Medical Center in Boston, and collaborators looked at 1,655 participants in the Modification of Diet in Renal Disease Study, which was conducted from 1989 to 1993. The group included 793 randomized and 862 non-randomized subjects.
The study population had a mean age of 50 years and a glomerular filtration rate (GFR) of 39 mL/min/1.73 m2 using iothalamate measurements. Dr. Menon's group ascertained survival status and cause of death, up to December 2000, using the National Death Index.
Subjects with anemia (defined as a hemoglobin level below 13.5 g/dL in men and below 12 g/dL in women) had lower BMI, LDL-cholesterol, HDL-cholesterol, GFR, and iron levels, and higher systolic BP and proteinuria. They also were more likely to be non-white and female.
Hemoglobin correlated directly with GFR, the study found. Compared with non-anemic patients, those with anemia had a 35% and 46% increased risk of all-cause and cardiovascular (CV) mortality, respectively, in unadjusted analyses.
When researchers adjusted for age, gender, race, BMI, history of CV disease, randomized status, LDL-cholesterol, and systolic BP, anemic patients had a 42% and 48% increased risk of all-cause and CV mortality, respectively. However, these increased risks disappeared when the researchers added GFR to the aforementioned variables.