Kidney Week

Abstract: TH-PO293

Are Hemoglobin Levels Affected by Sex, Age, and Race in Dialysis Patients?

Session Information

• Dialysis: Cost, Socioeconomics, Quality of Life
  October 25, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

• 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

• Reviriego-Mendoza, Marta, Fresenius Medical Care North America, Waltham, Massachusetts, United States

Marta Reviriego-Mendoza,

• Rosen, Sophia, Fresenius Medical Care North America, Waltham, Massachusetts, United States

Sophia Rosen,

• Maddux, Dugan, Fresenius Medical Care North America, Waltham, Massachusetts, United States

Dugan Maddux,

• Larkin, John W., Fresenius Medical Care North America, Waltham, Massachusetts, United States

John W. Larkin,

• Usvyat, Len A., Fresenius Medical Care North America, Waltham, Massachusetts, United States

Len A. Usvyat,

• Maddux, Franklin W., Fresenius Medical Care North America, Waltham, Massachusetts, United States

Franklin W. Maddux,

Background

In the general population, women have lower reference ranges for hemoglobin (Hgb) levels compared to men, yet no differences are considered for anemia targets in people with chronic kidney disease (CKD). We aimed to explore if differences exist in Hgb levels between men and women initiating dialysis within different age groups and races.

Methods

Data from all incident patients in the United States Renal Data System (USRDS) from 2011-2015 was utilized via the RenDER system. Patients’ were separated by sex, race (Asian (ASN), Black (BLK) and White (WHT), and age groups (0-19 years old (y/o), 20-39, 40-55, 56-79 and 80+). Average Hgb levels were obtained from the 2728 Medical Evidence form and compared among categories. The sex gap in Hgb levels ((Female_Hgb-Male_Hgb)/Male_Hgb) is evaluated for each category.

Results

Data from a total of 481,823 patients was analyzed; 203,804 (42%) were women. Although anemia targets do not differ between men and women with CKD, women tend to have lower levels of Hgb when starting dialysis, and this difference is greater for younger women. Young BLK women show a -4% and a -5.3% difference at ages 0-19 and 20-39, respectively, when compared to men. For young WHT women, Hgb levels differ from men by a -5.3% for the 0-19 y/o group, and a -3.3% for the 20-39 y/o group. However, young ASN women tend to have a smaller gap/difference in Hgb levels when compared to men (between -1 to 1% for 0-19 y/o and 20-39 y/o). The sex gap/difference in Hgb levels becomes less apparent in older age groups of women for the races analyzed (Figure 1).

Conclusion

Findings suggest that there may be differences in Hgb levels between the sexes that vary with age and race, which are most noticeable in WHT and BLK patients. More analyses are necessary to investigate if these sex, age and race dependent differences in Hgb levels affect health outcomes.

Funding

• Commercial Support – Fresenius Medical Care North America