TY - JOUR
T1 - Anemia as a risk factor for all-cause mortality
T2 - Obscure synergic effect of chronic kidney disease
AU - Sato, Yuji
AU - Fujimoto, Shouichi
AU - Konta, Tsuneo
AU - Iseki, Kunitoshi
AU - Moriyama, Toshiki
AU - Yamagata, Kunihiro
AU - Tsuruya, Kazuhiko
AU - Narita, Ichiei
AU - Kondo, Masahide
AU - Kasahara, Masato
AU - Shibagaki, Yugo
AU - Asahi, Koichi
AU - Watanabe, Tsuyoshi
N1 - Funding Information:
Acknowledgements This work was supported by the Health and Labor Sciences Research Grants for ‘‘Design of the Comprehensive Health Care System for Chronic Kidney Disease Based on the Individual Risk Assessment by Specific Health Check’’ from the Ministry of Health, Labour and Welfare of Japan, and a Grant-in-Aid for ‘‘Research on Advanced Chronic Kidney Disease (REACH-J), Practical Research Project for Renal Disease’’ from the Japan Agency for Medical Research and Development.
Publisher Copyright:
© Japanese Society of Nephrology 2017.
PY - 2018/4
Y1 - 2018/4
N2 - Background Anemia is common in chronic kidney disease (CKD) and may be associated with mortality in CKD patients. However, few studies have examined this relationship in Asian populations. Methods A total of 62,931 Japanese people (age 64.0 ± 8.0 years; men 38.5%) were followed up from 2008 to 2012. Participants were divided into six groups in accordance with their estimated glomerular filtration rate (eGFR) (<45, 45-59, ≥60 mL/min/1.73 m2) and by hemoglobin levels (13.0 g/dL for men; 12.0 g/dL for women). Hazard ratio and confidence interval (CI) for mortality with a combination of eGFR and anemia were calculated. After matching using propensity score (PS) for anemia, survival analysis between anemic and non-anemic people, independent from some variables, including eGFR, was performed. Results A total of 828 (1.3%) participants died (non-anemic vs. anemic, 1.2 vs. 2.3%, p < 0.01). Multivariable Cox analysis showed that, independent of eGFR levels, anemic people had significantly higher mortality. Anemic people were found to have significantly poorer survival than non-anemic people as per a log-rank test (p < 0.01) for the PS-matching cohort. Further stratified logistic analysis using PS in the overall cohort odds ratio (95% CI) showed 2.25 (1.89-2.67) with p < 0.01. Conclusion The results of the present study showed that anemia was an independent risk factor of all-cause mortality.
AB - Background Anemia is common in chronic kidney disease (CKD) and may be associated with mortality in CKD patients. However, few studies have examined this relationship in Asian populations. Methods A total of 62,931 Japanese people (age 64.0 ± 8.0 years; men 38.5%) were followed up from 2008 to 2012. Participants were divided into six groups in accordance with their estimated glomerular filtration rate (eGFR) (<45, 45-59, ≥60 mL/min/1.73 m2) and by hemoglobin levels (13.0 g/dL for men; 12.0 g/dL for women). Hazard ratio and confidence interval (CI) for mortality with a combination of eGFR and anemia were calculated. After matching using propensity score (PS) for anemia, survival analysis between anemic and non-anemic people, independent from some variables, including eGFR, was performed. Results A total of 828 (1.3%) participants died (non-anemic vs. anemic, 1.2 vs. 2.3%, p < 0.01). Multivariable Cox analysis showed that, independent of eGFR levels, anemic people had significantly higher mortality. Anemic people were found to have significantly poorer survival than non-anemic people as per a log-rank test (p < 0.01) for the PS-matching cohort. Further stratified logistic analysis using PS in the overall cohort odds ratio (95% CI) showed 2.25 (1.89-2.67) with p < 0.01. Conclusion The results of the present study showed that anemia was an independent risk factor of all-cause mortality.
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U2 - 10.1007/s10157-017-1468-8
DO - 10.1007/s10157-017-1468-8
M3 - Article
AN - SCOPUS:85027506046
SN - 1342-1751
VL - 22
SP - 388
EP - 394
JO - Clinical and Experimental Nephrology
JF - Clinical and Experimental Nephrology
IS - 2
ER -