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Kidney Week

Abstract: TH-PO266

Associations of Anemia with Quality of Life in CKD Stage 3-5 Patients: Results from CKDopps in the US and Brazil

Session Information

Category: CKD (Non-Dialysis)

  • 1901 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention


  • Sukul, Nidhi, University of Michigan, Ann Arbor, Michigan, United States
  • Muenz, Daniel G., Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
  • Speyer, Elodie, CESP Inserm U1018, VILLEJUIF Cedex, France
  • Lopes, Antonio Alberto, Faculdade de Medicina da Universidade Federal da Bahia, Salvador, BAHIA, Brazil
  • Asahi, Koichi, Fukushima Medical University School of Medicine, Fukushima, Japan
  • Hoshino, Junichi, Toranomon Hospital, Tokyo, Japan
  • Dhalwani, Nafeesa N., Evidera, London, United Kingdom
  • van Haalen, Heleen, AstraZeneca, Gothenburg, Sweden
  • Pecoits-Filho, Roberto, Pontificia Universidade Catolica do Parana, Curitiba, PARANÁ, Brazil
  • Bieber, Brian, Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
  • Robinson, Bruce M., Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
  • Pisoni, Ronald L., Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States

The risk of anemia increases with chronic kidney disease (CKD) progression. Some studies suggest that anemia is associated with poorer quality of life (QOL) among non-dialysis CKD patients. Using the Chronic Kidney Disease Outcomes and Practice Patterns Study (CKDopps), we report the associations of anemia with QOL outcomes among CKD patients in the US and Brazil.


We analyzed CKDopps data on patient characteristics, laboratory measurements and the Kidney Disease QOL-36 (KDQOL-36) survey collected prospectively for stage 3-5 CKD patients (N=1212) at 22 US and 15 Brazilian nephrologist-run clinics from 2014-2018. Hemoglobin (Hgb) levels, reported closest in time to KDQOL-36 completion (median gap: 13 days, IQR: 1-57 days), were modelled separately as continuous and categorical exposures in GEE linear regression models for each QOL outcome, adjusting for country, age, sex, race, smoking history, eGFR, serum albumin, and 13 comorbidities, and accounting for clustering by clinic.


More severe anemia was most strongly associated with poorer scores for QOL domains of general health, physical role, emotional role, burden, effects of kidney disease, as well as the physical and mental component summary scores. Weak to moderate associations were observed with the domains of energy, physical function, and pain.


These findings show moderate associations between anemia and poorer outcomes on several QOL domains in CKD stage 3-5 patients from the US and Brazil, even after accounting for numerous comorbidities. Longitudinal studies would be valuable to understand how patient QOL and well-being are impacted by anemia and its treatment over time.


  • NIDDK Support