Albuminuria as a risk factor for anemia in chronic kidney disease

Result from the Korean cohort study for outcomes in patients with chronic kidney disease (KNOW-CKD)

Ji Suk Han, Mi Jung Lee, Kyoung Sook Park, SeungHyeok Han, TaeHyun Yoo, Kook Hwan Oh, Sue Kyung Park, Joongyub Lee, Young Youl Hyun, Wookyung Chung, Yeong Hoon Kim, Curie Ahn, Kyu Hun Choi

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background Anemia is a common complication among patients with chronic kidney disease (CKD), and it is associated with unfavorable clinical outcomes in patients with CKD independent of the estimated glomerular filtration rate (eGFR). We assessed the association of the urinary albumin-to-creatinine ratio (ACR) and eGFR with anemia in CKD patients. Methods We conducted a cross-sectional study using baseline data from the KoreaN Cohort Study for Outcome in Patients With Chronic Kidney Disease (KNOW-CKD). Multiple regression analysis was performed to identify the independent association of albuminuria with anemia. Furthermore, odds ratios for anemia were calculated by cross-categorization of ACR and eGFR. Results Among 1,456 patients, the mean age was 53.5 12.4 years, and the mean eGFR and ACR were 51.9 30.5 mL/min per 1.73 m2 and 853.2 1,330.3 mg/g, respectively. Anemia was present in 644 patients (40.5%). Multivariate analysis showed that the odds ratio of anemia increased according to ACR levels, after adjusting for age, sex, eGFR, body mass index, pulse pressure, cause of CKD, use of erythropoiesis stimulating agents, serum calcium and ferritin (ACR 30 mg/g as a reference group; 30-299 mg/g, adjusted odds ratio (OR) = 1.43, 95% confidence interval (CI) = 0.88-2.33; 300 mg/g, adjusted OR = 1.86, 95% CI = 1.12-3.10). In addition, graded associations were observed in cross-categorized groups of a higher ACR and eGFR compared to the reference group with an ACR 30mg/g and eGFR 60mL/min per 1.73 m2. Conclusion The present study demonstrated that albuminuria was a significant risk factor for anemia in CKD patients independent of the eGFR.

Original languageEnglish
Article numbere139747
JournalPloS one
Volume10
Issue number10
DOIs
Publication statusPublished - 2015 Oct 2

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Albuminuria
glomerular filtration rate
kidney diseases
cohort studies
Glomerular Filtration Rate
Chronic Renal Insufficiency
anemia
Anemia
creatinine
Cohort Studies
risk factors
albumins
Albumins
Creatinine
odds ratio
Odds Ratio
confidence interval
Confidence Intervals
Hematinics
erythropoiesis

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Han, Ji Suk ; Lee, Mi Jung ; Park, Kyoung Sook ; Han, SeungHyeok ; Yoo, TaeHyun ; Oh, Kook Hwan ; Park, Sue Kyung ; Lee, Joongyub ; Hyun, Young Youl ; Chung, Wookyung ; Kim, Yeong Hoon ; Ahn, Curie ; Choi, Kyu Hun. / Albuminuria as a risk factor for anemia in chronic kidney disease : Result from the Korean cohort study for outcomes in patients with chronic kidney disease (KNOW-CKD). In: PloS one. 2015 ; Vol. 10, No. 10.
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abstract = "Background Anemia is a common complication among patients with chronic kidney disease (CKD), and it is associated with unfavorable clinical outcomes in patients with CKD independent of the estimated glomerular filtration rate (eGFR). We assessed the association of the urinary albumin-to-creatinine ratio (ACR) and eGFR with anemia in CKD patients. Methods We conducted a cross-sectional study using baseline data from the KoreaN Cohort Study for Outcome in Patients With Chronic Kidney Disease (KNOW-CKD). Multiple regression analysis was performed to identify the independent association of albuminuria with anemia. Furthermore, odds ratios for anemia were calculated by cross-categorization of ACR and eGFR. Results Among 1,456 patients, the mean age was 53.5 12.4 years, and the mean eGFR and ACR were 51.9 30.5 mL/min per 1.73 m2 and 853.2 1,330.3 mg/g, respectively. Anemia was present in 644 patients (40.5{\%}). Multivariate analysis showed that the odds ratio of anemia increased according to ACR levels, after adjusting for age, sex, eGFR, body mass index, pulse pressure, cause of CKD, use of erythropoiesis stimulating agents, serum calcium and ferritin (ACR 30 mg/g as a reference group; 30-299 mg/g, adjusted odds ratio (OR) = 1.43, 95{\%} confidence interval (CI) = 0.88-2.33; 300 mg/g, adjusted OR = 1.86, 95{\%} CI = 1.12-3.10). In addition, graded associations were observed in cross-categorized groups of a higher ACR and eGFR compared to the reference group with an ACR 30mg/g and eGFR 60mL/min per 1.73 m2. Conclusion The present study demonstrated that albuminuria was a significant risk factor for anemia in CKD patients independent of the eGFR.",
author = "Han, {Ji Suk} and Lee, {Mi Jung} and Park, {Kyoung Sook} and SeungHyeok Han and TaeHyun Yoo and Oh, {Kook Hwan} and Park, {Sue Kyung} and Joongyub Lee and Hyun, {Young Youl} and Wookyung Chung and Kim, {Yeong Hoon} and Curie Ahn and Choi, {Kyu Hun}",
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Albuminuria as a risk factor for anemia in chronic kidney disease : Result from the Korean cohort study for outcomes in patients with chronic kidney disease (KNOW-CKD). / Han, Ji Suk; Lee, Mi Jung; Park, Kyoung Sook; Han, SeungHyeok; Yoo, TaeHyun; Oh, Kook Hwan; Park, Sue Kyung; Lee, Joongyub; Hyun, Young Youl; Chung, Wookyung; Kim, Yeong Hoon; Ahn, Curie; Choi, Kyu Hun.

In: PloS one, Vol. 10, No. 10, e139747, 02.10.2015.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Albuminuria as a risk factor for anemia in chronic kidney disease

T2 - Result from the Korean cohort study for outcomes in patients with chronic kidney disease (KNOW-CKD)

AU - Han, Ji Suk

AU - Lee, Mi Jung

AU - Park, Kyoung Sook

AU - Han, SeungHyeok

AU - Yoo, TaeHyun

AU - Oh, Kook Hwan

AU - Park, Sue Kyung

AU - Lee, Joongyub

AU - Hyun, Young Youl

AU - Chung, Wookyung

AU - Kim, Yeong Hoon

AU - Ahn, Curie

AU - Choi, Kyu Hun

PY - 2015/10/2

Y1 - 2015/10/2

N2 - Background Anemia is a common complication among patients with chronic kidney disease (CKD), and it is associated with unfavorable clinical outcomes in patients with CKD independent of the estimated glomerular filtration rate (eGFR). We assessed the association of the urinary albumin-to-creatinine ratio (ACR) and eGFR with anemia in CKD patients. Methods We conducted a cross-sectional study using baseline data from the KoreaN Cohort Study for Outcome in Patients With Chronic Kidney Disease (KNOW-CKD). Multiple regression analysis was performed to identify the independent association of albuminuria with anemia. Furthermore, odds ratios for anemia were calculated by cross-categorization of ACR and eGFR. Results Among 1,456 patients, the mean age was 53.5 12.4 years, and the mean eGFR and ACR were 51.9 30.5 mL/min per 1.73 m2 and 853.2 1,330.3 mg/g, respectively. Anemia was present in 644 patients (40.5%). Multivariate analysis showed that the odds ratio of anemia increased according to ACR levels, after adjusting for age, sex, eGFR, body mass index, pulse pressure, cause of CKD, use of erythropoiesis stimulating agents, serum calcium and ferritin (ACR 30 mg/g as a reference group; 30-299 mg/g, adjusted odds ratio (OR) = 1.43, 95% confidence interval (CI) = 0.88-2.33; 300 mg/g, adjusted OR = 1.86, 95% CI = 1.12-3.10). In addition, graded associations were observed in cross-categorized groups of a higher ACR and eGFR compared to the reference group with an ACR 30mg/g and eGFR 60mL/min per 1.73 m2. Conclusion The present study demonstrated that albuminuria was a significant risk factor for anemia in CKD patients independent of the eGFR.

AB - Background Anemia is a common complication among patients with chronic kidney disease (CKD), and it is associated with unfavorable clinical outcomes in patients with CKD independent of the estimated glomerular filtration rate (eGFR). We assessed the association of the urinary albumin-to-creatinine ratio (ACR) and eGFR with anemia in CKD patients. Methods We conducted a cross-sectional study using baseline data from the KoreaN Cohort Study for Outcome in Patients With Chronic Kidney Disease (KNOW-CKD). Multiple regression analysis was performed to identify the independent association of albuminuria with anemia. Furthermore, odds ratios for anemia were calculated by cross-categorization of ACR and eGFR. Results Among 1,456 patients, the mean age was 53.5 12.4 years, and the mean eGFR and ACR were 51.9 30.5 mL/min per 1.73 m2 and 853.2 1,330.3 mg/g, respectively. Anemia was present in 644 patients (40.5%). Multivariate analysis showed that the odds ratio of anemia increased according to ACR levels, after adjusting for age, sex, eGFR, body mass index, pulse pressure, cause of CKD, use of erythropoiesis stimulating agents, serum calcium and ferritin (ACR 30 mg/g as a reference group; 30-299 mg/g, adjusted odds ratio (OR) = 1.43, 95% confidence interval (CI) = 0.88-2.33; 300 mg/g, adjusted OR = 1.86, 95% CI = 1.12-3.10). In addition, graded associations were observed in cross-categorized groups of a higher ACR and eGFR compared to the reference group with an ACR 30mg/g and eGFR 60mL/min per 1.73 m2. Conclusion The present study demonstrated that albuminuria was a significant risk factor for anemia in CKD patients independent of the eGFR.

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