Optimal hemoglobin level for anemia treatment in a cohort of hemodialysis patients

• Published in: Kidney research and clinical practice Vol. 34; no. 1; pp. 20 - 27
• Main Authors: Jung, Mi Yeon, Hwang, Soon Young, Hong, Yu Ah, Oh, Su Young, Seo, Jae Hee, Lee, Young Mo, Park, Sang Won, Kim, Jung Sun, Wang, Joon Kwang, Kim, Jeong Yup, Lee, Ji Eun, Ko, Gang Jee, Pyo, Heui Jung, Kwon, Young Joo
• Format: Journal Article
• Language: English
• Published: Korea (South) Elsevier B.V 01.03.2015; Elsevier; The Korean Society of Nephrology; 대한신장학회
• Subjects: Anemia; Hemodialysis; Hemoglobin; Mortality; Nephrology; Original; 내과학; Hemoglobin; Anemia; Hemodialysis; Mortality
• ISSN: 2211-9132; 2211-9140
• DOI: 10.1016/j.krcp.2014.11.003

Abstract Background Anemia is a major risk factor that contributes to mortality in patients with chronic kidney disease. There is controversy over the optimal hemoglobin (Hb) target in these patients. This study investigated the association between Hb level and mortality in a cohort of hemodialysis (HD) patients in Korea. Methods This study was a multicenter prospective observational study of maintenance HD patients that was performed for 5 years in western Seoul, Korea. Three hundred and sixty-two participants were enrolled. Laboratory values and mortality were accessed every 6 months. Repeated measures of laboratory values in each interval were averaged to obtain one semiannual mean value. The Hb values were divided into six groups: (1) Hb<9 g/dL; (2) 9 g/dL≤Hb<10 g/dL; (3) 10 g/dL≤Hb<11 g/dL; (4) 11 g/dL≤Hb<12 g/dL; (5) 12 g/dL≤Hb<13 g/dL; and (6) Hb≥13 g/dL. We analyzed the odds ratio for all-cause mortality, based on the Hb group, and adjusted for demographics and various laboratory values. Statistics were performed with SAS, version 9.1 software (SAS Institute Inc., Cary, NC, USA). Results Mortality odds ratios relative to the reference group (10–11 g/dL) in the fully adjusted model were 3.61 for<9 g/dL; 3.17 for 9–10 g/dL⁎ ; 4.65 for 11–12 g/dL⁎ ; 5.50 for 12–13 g/dL⁎ ; and 2.05 for≥13 g/dL (⁎ indicates P <0.05). Conclusion In this study, a Hb level of 10–11 g/dL was associated with the lowest mortality among the groups with Hb level<13 g/dL. Larger interventional trials are warranted to determine the optimal Hb target for Korean HD patients.