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

Mi Yeon Jung, Soon Young Hwang, Yu Ah Hong, Su Young Oh, Jae Hee Seo, Young Mo Lee, Sang Won Park, Jung Sun Kim, Joon Kwang Wang, Jeong Yup Kim, Ji Eun Lee, Gang Jee Ko, Heui Jung Pyo, Young-Joo Kwon

Research output: Contribution to journalArticle

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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;Hb<11 g/dL; (4) 11 g/dL≤ Hblt&12 g/dL; (5) 12 g/dL≤ Hb;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/dLz.ast;; 4.65 for 11-12 g/dLz.ast;; 5.50 for 12-13 g/dLz.ast;; and 2.05 for 13 g/dL (z.ast; 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.

Original languageEnglish
Pages (from-to)20-27
Number of pages8
JournalKidney Research and Clinical Practice
Volume34
Issue number1
DOIs
Publication statusPublished - 2015 Mar 1

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Renal Dialysis
Anemia
Hemoglobins
Therapeutics
Mortality
Korea
Odds Ratio
Chronic Renal Insufficiency
Observational Studies
Software
Maintenance
Demography
Prospective Studies

Keywords

  • Anemia
  • Hemodialysis
  • Hemoglobin
  • Mortality

ASJC Scopus subject areas

  • Nephrology
  • Urology

Cite this

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

In: Kidney Research and Clinical Practice, Vol. 34, No. 1, 01.03.2015, p. 20-27.

Research output: Contribution to journalArticle

Jung, MY, Hwang, SY, Hong, YA, Oh, SY, Seo, JH, Lee, YM, Park, SW, Kim, JS, Wang, JK, Kim, JY, Lee, JE, Ko, GJ, Pyo, HJ & Kwon, Y-J 2015, 'Optimal hemoglobin level for anemia treatment in a cohort of hemodialysis patients', Kidney Research and Clinical Practice, vol. 34, no. 1, pp. 20-27. https://doi.org/10.1016/j.krcp.2014.11.003
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. / Optimal hemoglobin level for anemia treatment in a cohort of hemodialysis patients. In: Kidney Research and Clinical Practice. 2015 ; Vol. 34, No. 1. pp. 20-27.
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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;Hb<11 g/dL; (4) 11 g/dL≤ Hblt&12 g/dL; (5) 12 g/dL≤ Hb;Hb<13 g/dL; and (6) Hb{\^a}‰¥ 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/dLz.ast;; 4.65 for 11-12 g/dLz.ast;; 5.50 for 12-13 g/dLz.ast;; and 2.05 for 13 g/dL (z.ast; 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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T1 - Optimal hemoglobin level for anemia treatment in a cohort of hemodialysis patients

AU - Jung, Mi Yeon

AU - Hwang, Soon Young

AU - Hong, Yu Ah

AU - Oh, Su Young

AU - Seo, Jae Hee

AU - Lee, Young Mo

AU - Park, Sang Won

AU - Kim, Jung Sun

AU - Wang, Joon Kwang

AU - Kim, Jeong Yup

AU - Lee, Ji Eun

AU - Ko, Gang Jee

AU - Pyo, Heui Jung

AU - Kwon, Young-Joo

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N2 - 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;Hb<11 g/dL; (4) 11 g/dL≤ Hblt&12 g/dL; (5) 12 g/dL≤ Hb;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/dLz.ast;; 4.65 for 11-12 g/dLz.ast;; 5.50 for 12-13 g/dLz.ast;; and 2.05 for 13 g/dL (z.ast; 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.

AB - 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;Hb<11 g/dL; (4) 11 g/dL≤ Hblt&12 g/dL; (5) 12 g/dL≤ Hb;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/dLz.ast;; 4.65 for 11-12 g/dLz.ast;; 5.50 for 12-13 g/dLz.ast;; and 2.05 for 13 g/dL (z.ast; 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.

KW - Anemia

KW - Hemodialysis

KW - Hemoglobin

KW - Mortality

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