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Abstract: TH-PO264

Differential Effect of Hemoglobin Level on Patient Mortality According to Patient Age in ESRD Patients

Session Information

Category: Anemia and Iron Metabolism

  • 202 Anemia and Iron Metabolism: Clinical

Authors

  • Ko, Eun jeong, Seoul St.Mary''s Hospital, Seoul, Korea (the Republic of)
  • Choi, Bumsoon, Division of Nephrology, Department of Internal Medicine, Seoul, Korea (the Republic of)
  • Park, Cheol Whee, The Catholic University of Korea, Seoul, Korea (the Republic of)
  • Yang, Chul Woo, Seoul St. Mary's Hospital, Seoul, Korea (the Republic of)
  • Chung, Byung ha, Seoul St. Mary's Hospital, Seoul, Korea (the Republic of)
Background

In chronic dialysis patients, achieving an adequate hemoglobin (Hb) concentration is very important because lower than 10 g/dL or higher than 12g/dl can be associated with increased patient mortality. However, it has not been confirmed that it can be applied irrespective of patient age. Therefore, the aim of this study is to investigate the impact of Hb level on the clinical outcomes of dialysis patients according to patient age using the Clinical Research Center registry for end-stage renal disease (CRC-ESRD) data.

Methods

A total of 3,409 patients form CRC-ESRD were included. They were divided into three group by age, age < 40 (n=488), 40<age≤60 (n=1,650), and age >60 (n=1,271). We compared the overall mortality, cardiovascular mortality, all-cause and cardiovascular hospitalization according to mean Hb level.

Results

In age <40 group, Hb ≥12 g/dl group showed higher all-cause mortality (adjusted HR 3.894, 95% CI 1.037-14.624; p=0.044) compared to 10≤Hb <12 g/dl group, whereas HR of cardiovascular hospitalization was higher in Hb < 10g/dl group (adjusted HR 2.268; 95% CI 1.044-4.926, p=0.039). Meanwhile, in age≥60 group, all-cause and cardiovascular mortality was higher in Hb <10 g/dl (adjusted HR 2.098, 95% CI 1.567-2.808, p<0.001 and adjusted HR 2.796, 95% CI 1.669-4.686, p<0.001) compared to 10≤ Hb < 12g/dl group, however the difference between 10≤ Hb < 12g/dl group and Hb ≥ 12g/dl was not significant. In 40<age≤ 60 group, Hb <10g/dl showed higher all-cause mortality (adjusted HR 1.719, 95% CI 1.158-2.252, p=0.007), all-cause hospitalization (adjusted HR 1.572, 95% CI 1.213-2.036, p=0.001) and cardiovascular hospitalization (adjusted HR 1.455, 95% CI 1.037-2.043, p=0.030) compared to 10≤Hb <12 g/dl group, whereas there was no significant difference between 10≤Hb <12 and Hb ≥ 12 g/dl group

Conclusion

Thus, in elderly patient on dialysis, the effect of low or higher hemoglobin level than 10 - 12 g/dL in elderly patients was different from that in young patient.

Funding

  • Government Support - Non-U.S.