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The differential effects of anemia on mortality in young and elderly end-stage renal disease patients

Authors
 Eun Jeong Ko  ;  Yong Kyun Kim  ;  Jang-Hee Cho  ;  Yon Su Kim  ;  Shin-Wook Kang  ;  Nam-Ho Kim  ;  Yong-Lim Kim  ;  Chul Woo Yang  ;  Byung Ha Chung 
Citation
 KIDNEY RESEARCH AND CLINICAL PRACTICE, Vol.39(2) : 192-201, 2020-06 
Journal Title
KIDNEY RESEARCH AND CLINICAL PRACTICE
ISSN
 2211-9132 
Issue Date
2020-06
Keywords
Aged ; Cardiovascular diseases ; Dialysis ; Hemoglobin target ; Mortality
Abstract
Background: The aim of this study was to compare the effect of anemia on clinical outcomes according to age in patients with end-stage renal disease (ESRD).

Methods: A total of 3,409 patients from the Clinical Research Center for ESRD were included and divided into three groups by age: age < 40 (n = 488), 40 ≤ age < 60 (n = 1,650), and age ≥ 60 (n = 1,271). We compared overall and cardiovascular mortality, and all-cause and cardiovascular hospitalization according to mean hemoglobin (Hb) concentration.

Results: Among participants ≥ 60 years of age, the Hb < 10 g/dL group had greater all-cause mortality (adjusted hazard ratio [HR], 2.098; 95% confidence interval [CI], 1.567-2.808; P < 0.001) than the 10 ≤ Hb < 12 g/dL group, whereas among participants < 40 years of age, the Hb ≥ 12 g/dL group had greater mortality than the 10 ≤ Hb < 12 g/dL group. Moreover, in participants ≥ 60 years of age, the HR for all-cause hospitalization for the Hb < 10 g/dL group was significantly greater than that of the 10 ≤ Hb < 12 g/dL group (HR, 1.472; 95% CI, 1.057-2.051; P = 0.022), whereas it was significantly lower in the Hb ≥ 12 g/dL group (HR, 0.544; 95% CI, 0.362-0.820; P = 0.004) However, among participants < 40 years of age, the incidence of all-cause hospitalization did not differ according to the Hb concentration (HR, 1.273; 95% CI, 0.814-1.991; P = 0.290 for the Hb < 10 g/dL group; reference, 10 ≤ Hb < 12 g/dL; HR, 0.787; 95% CI, 0.439-1.410; P = 0.265 for Hb ≥ 12 g/dL group).

Conclusion: The impact of anemia on mortality was more significant in elderly ESRD patients. Strict monitoring and management of anemia should be required for elderly ESRD patients.
Files in This Item:
T999202297.pdf Download
DOI
10.23876/j.krcp.19.120
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Ophthalmology (안과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Shin Wook(강신욱) ORCID logo https://orcid.org/0000-0002-5677-4756
Byeon, Suk Ho(변석호) ORCID logo https://orcid.org/0000-0001-8101-0830
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/184995
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