Optimal hemoglobin level for anemia treatment in a cohort of hemodialysis patients
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...
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| Published in | Kidney research and clinical practice Vol. 34; no. 1; pp. 20 - 27 |
|---|---|
| Main Authors | , , , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Korea (South)
Elsevier B.V
01.03.2015
Elsevier The Korean Society of Nephrology 대한신장학회 |
| Subjects | |
| Online Access | Get full text |
| ISSN | 2211-9132 2211-9140 |
| DOI | 10.1016/j.krcp.2014.11.003 |
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| Abstract | 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. |
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| AbstractList | 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.
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<9g/dL; (2) 9g/dL≤Hb<10g/dL; (3) 10g/dL≤Hb<11g/dL; (4) 11g/dL≤Hb<12g/dL; (5) 12g/dL≤Hb<13g/dL; and (6) Hb≥13g/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).
Mortality odds ratios relative to the reference group (10–11g/dL) in the fully adjusted model were 3.61 for<9g/dL; 3.17 for 9–10g/dL⁎; 4.65 for 11–12g/dL⁎; 5.50 for 12–13g/dL⁎; and 2.05 for≥13g/dL (⁎ indicates P<0.05).
In this study, a Hb level of 10–11g/dL was associated with the lowest mortality among the groups with Hb level<13g/dL. Larger interventional trials are warranted to determine the optimal Hb target for Korean HD patients. 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. 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). 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). 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. 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. Background: Anemia is a major risk factor that contributes to mortality in patientswith chronic kidney disease. There is controversy over the optimal hemoglobin (Hb)target in these patients. This study investigated the association between Hb leveland mortality in a cohort of hemodialysis (HD) patients in Korea. Methods: This study was a multicenter prospective observational study of maintenanceHD patients that was performed for 5 years in western Seoul, Korea. Threehundred and sixty-two participants were enrolled. Laboratory values and mortalitywere accessed every 6 months. Repeated measures of laboratory values in eachinterval were averaged to obtain one semiannual mean value. The Hb values weredivided into six groups: (1) Hbo9 g/dL; (2) 9 g/dLrHbo10 g/dL; (3) 10 g/dLrHbo11 g/dL; (4) 11 g/dLrHbo12 g/dL; (5) 12 g/dLrHbo13 g/dL; and (6)HbZ13 g/dL. We analyzed the odds ratio for all-cause mortality, based on the Hbgroup, and adjusted for demographics and various laboratory values. Statistics wereperformed 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 fullyadjusted model were 3.61 foro9 g/dL; 3.17 for 9–10 g/dLn; 4.65 for 11–12 g/dLn; 5.50for 12–13 g/dLn; and 2.05 forZ13 g/dL (n indicates Po0.05). Conclusion: In this study, a Hb level of 10–11 g/dL was associated with the lowestmortality among the groups with Hb levelo13 g/dL. Larger interventional trials arewarranted to determine the optimal Hb target for Korean HD patients. KCI Citation Count: 2 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.BACKGROUNDAnemia 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.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).METHODSThis 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).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).RESULTSMortality 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).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.CONCLUSIONIn 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. 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. |
| Author | Hong, Yu Ah Seo, Jae Hee Kim, Jeong Yup Lee, Ji Eun Wang, Joon Kwang Hwang, Soon Young Lee, Young Mo Jung, Mi Yeon Ko, Gang Jee Park, Sang Won Pyo, Heui Jung Kwon, Young Joo Kim, Jung Sun Oh, Su Young |
| AuthorAffiliation | 4 Division of Nephrology, Department of Internal Medicine, Won Kwang University College of Medicine, Iksan, Korea 1 Division of Nephrology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea 2 Department of Biostatistics, Korea University College of Medicine, Seoul, Korea 3 Institute of Kidney Disease Research, Korea University College of Medicine, Seoul, Korea |
| AuthorAffiliation_xml | – name: 1 Division of Nephrology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea – name: 3 Institute of Kidney Disease Research, Korea University College of Medicine, Seoul, Korea – name: 4 Division of Nephrology, Department of Internal Medicine, Won Kwang University College of Medicine, Iksan, Korea – name: 2 Department of Biostatistics, Korea University College of Medicine, Seoul, Korea |
| Author_xml | – sequence: 1 fullname: Jung, Mi Yeon – sequence: 2 fullname: Hwang, Soon Young – sequence: 3 fullname: Hong, Yu Ah – sequence: 4 fullname: Oh, Su Young – sequence: 5 fullname: Seo, Jae Hee – sequence: 6 fullname: Lee, Young Mo – sequence: 7 fullname: Park, Sang Won – sequence: 8 fullname: Kim, Jung Sun – sequence: 9 fullname: Wang, Joon Kwang – sequence: 10 fullname: Kim, Jeong Yup – sequence: 11 fullname: Lee, Ji Eun – sequence: 12 fullname: Ko, Gang Jee – sequence: 13 fullname: Pyo, Heui Jung – sequence: 14 fullname: Kwon, Young Joo |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/26484015$$D View this record in MEDLINE/PubMed https://www.kci.go.kr/kciportal/ci/sereArticleSearch/ciSereArtiView.kci?sereArticleSearchBean.artiId=ART001977619$$DAccess content in National Research Foundation of Korea (NRF) |
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| Keywords | Hemoglobin Anemia Hemodialysis Mortality |
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| Snippet | Abstract Background Anemia is a major risk factor that contributes to mortality in patients with chronic kidney disease. There is controversy over the optimal... Anemia is a major risk factor that contributes to mortality in patients with chronic kidney disease. There is controversy over the optimal hemoglobin (Hb)... Background: Anemia is a major risk factor that contributes to mortality in patients with chronic kidney disease. There is controversy over the optimal... Background: Anemia is a major risk factor that contributes to mortality in patientswith chronic kidney disease. There is controversy over the optimal... |
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| SubjectTerms | Anemia Hemodialysis Hemoglobin Mortality Nephrology Original 내과학 |
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| Title | Optimal hemoglobin level for anemia treatment in a cohort of hemodialysis patients |
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