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

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

Research output: Contribution to journalArticle

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.

Original languageEnglish
Pages (from-to)192-201
Number of pages10
JournalKidney Research and Clinical Practice
Volume39
Issue number2
DOIs
Publication statusPublished - 2020 Jun

All Science Journal Classification (ASJC) codes

  • Nephrology
  • Urology

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    Ko, E. J., Kim, Y. K., Cho, J. H., Kim, Y. S., Kang, S. W., Kim, N. H., Kim, Y. L., Yang, C. W., & Chung, B. H. (2020). The differential effects of anemia on mortality in young and elderly end-stage renal disease patients. Kidney Research and Clinical Practice, 39(2), 192-201. https://doi.org/10.23876/j.krcp.19.120