Kidney Week

Abstract: FR-PO0396

Effect of Hemoglobin Increase on Major Adverse Kidney Events in Patients with AKI and Severe Anemia

Session Information

• AKI: Biomarkers, Diagnostics, and Risk Prediction
  October 23, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Acute Kidney Injury

• 102 AKI: Clinical, Outcomes, and Trials

Authors

• Navarro Blackaller, Guillermo, Hospital Civil de Guadalajara, Guadalajara, Jal., Mexico

Guillermo Navarro Blackaller, MD

• Chavez, Jonathan, Hospital Civil de Guadalajara, Guadalajara, Jal., Mexico

Jonathan Chavez, MD, PhD

• Medina, Ramon, Hospital Civil de Guadalajara, Guadalajara, Jal., Mexico

Ramon Medina, MD

• Alcantar Vallin, Maria de la Luz, Hospital Civil de Guadalajara, Guadalajara, Jal., Mexico

Maria de la Luz Alcantar Vallin, MD

• Garcia-Garcia, Guillermo, Hospital Civil de Guadalajara, Guadalajara, Jal., Mexico

Guillermo Garcia-Garcia, MD, FASN

• Mendoza Gaitán, Héctor Eduardo, Hospital Civil de Guadalajara, Guadalajara, Jal., Mexico

Héctor Eduardo Mendoza Gaitán, MD

• Renoirte, Karina, Hospital Civil de Guadalajara, Guadalajara, Jal., Mexico

Karina Renoirte, PhD

• Abundis Mora, Gabriela Jazmín, Hospital Civil de Guadalajara, Guadalajara, Jal., Mexico

Gabriela Jazmín Abundis Mora, MD

• Gómez, Juan Alberto, Hospital Civil de Guadalajara, Guadalajara, Jal., Mexico

Juan Alberto Gómez, MD

• Martínez Gallardo González, Alejandro, Hospital Civil de Guadalajara, Guadalajara, Jal., Mexico

Alejandro Martínez Gallardo González

Background

Acute kidney injury (AKI) is frequently accompanied by severe anemia, raising concerns that impaired oxygen delivery may accelerate kidney dysfunction. However, the clinical benefit of early hemoglobin (Hb) correction in this high-risk population remains uncertain. This study evaluated the association between early Hb correction and major adverse kidney events (MAKE).

Methods

We conducted a retrospective cohort study including hospitalized adults with AKI and baseline severe anemia (Hb <8.0 g/dL) between August 2020 and December 2024. Patients were stratified according to whether they achieved Hb correction (>10 g/dL) within the first 10 days of hospitalization. The primary outcome was MAKE at 10 days (MAKE10), defined as death, initiation of kidney replacement therapy (KRT), or ≥25% decline in estimated glomerular filtration rate (eGFR). Secondary outcomes included individual MAKE components and MAKE at 90 days (MAKE90). Multivariable logistic regression models were adjusted for age, sex, and baseline eGFR.

Results

Among 232 patients, 47 (20.3%) achieved Hb correction. Baseline characteristics were comparable between groups. Although unadjusted analyses suggested a lower incidence of MAKE10 in the correction group, adjusted analyses showed no significant association (adjusted OR 1.04; 95% CI 0.41–2.62). Hb correction was not associated with mortality, KRT initiation, persistent kidney dysfunction, or MAKE90. No differences were observed according to the correction strategy (transfusion alone vs transfusion plus erythropoiesis-stimulating agents).

Conclusion

In patients with AKI and severe anemia, early Hb correction to >10 g/dL was not associated with improved short- or medium-term outcomes, supporting a conservative and individualized management approach.

Funding

• NIDDK Support