Kidney Week

Abstract: FR-PO0627

Hemoglobin and CKD in Patients with Diabetes

Session Information

• Anemia: Global Burden, Disease Interactions, and Emerging Therapeutic Paradigms
  October 23, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Anemia and Iron Metabolism

• 200 Anemia and Iron Metabolism

Authors

• Swamy, Varsha, The University of Chicago, Chicago, Illinois, United States

Varsha Swamy, MD

• Kowalczyk, Nicholas Stanley, The University of Chicago, Chicago, Illinois, United States

Nicholas Stanley Kowalczyk, MD

• Saunders, Milda R., The University of Chicago, Chicago, Illinois, United States

Milda R. Saunders, MD, MPH

• McGill, Rita L., The University of Chicago, Chicago, Illinois, United States

Rita L. McGill, MD, MS, FASN

Background

Anemia is common in patients with chronic kidney disease (CKD) and is associated with worse renal and cardiovascular outcomes. Aside from erythropoietin deficiency, CKD patients may also have malnutrition, functional iron deficiency due to chronic inflammation, or other bone marrow disorders that contribute to anemia. Patients with diabetes are also at higher risk for anemia due to underlying kidney disease and inflammation from dysglycemia. The purpose of our study was to evaluate the relationship between hemoglobin (hgb) and estimated glomerular filtration rate (eGFR) in patients with diabetes and CKD at the University of Chicago to inform decisions regarding anemia management.

Methods

Electronic medical records were reviewed of all diabetic patients seen in our primary care, endocrinology, and nephrology clinics from 1/1/2019-6/30/2025. Demographics were collected and all specimens with simultaneous hgb and eGFR were included.

Results

There were 338,740 specimens from 23,954 patients. Mean age at draw-date was 63±14 years; 58% were female, 61% were Black, 25% were White, 7% were Hispanic and 7% were other/unknown. One or more instances of anemia (defined by World Health Organization as hgb<13 in men and hgb<12 in women) were seen in 61% of women and 60% of men. Being female, Black, or Hispanic were all associated with lower hgb, as were cardiovascular disease and cancer. Hgb according to CKD stage is shown in Figure 1. The 5th percentile for hgb (in g/dL) was 8.1 for patients without CKD, 7.9/7.6 in stages 3a/3b, 7.1 in stage 4, and 6.9 in patients with Stage 5 or kidney failure.

Conclusion

While there is an association between CKD stage and hgb, hgb levels below 7.0 g/dL should prompt evaluation for other contributing causes of anemia.