Kidney Week

Abstract: PUB074

Increase in Hemoglobin Levels in Patients with Advanced CKD with Severe Anemia and Major Adverse Kidney Events

Session Information

• Publication Only

Category: Anemia and Iron Metabolism

• 200 Anemia and Iron Metabolism

Authors

• Chavez, Jonathan, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico

Jonathan Chavez, PhD

• Garcia-Garcia, Guillermo, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico

Guillermo Garcia-Garcia, MD, FASN

• Medina, Ramon, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico

Ramon Medina, MD

• Hernandez Morales, Karla, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico

Karla Hernandez Morales, MD

• Camacho, Jahir Ricardo, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico

Jahir Ricardo Camacho, MD

• Carmona, Edgar Joel, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico

Edgar Joel Carmona, MD

• Oseguera Gonzalez, Alexa Nicole, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico

Alexa Nicole Oseguera Gonzalez, MD

• Murguía Soto, César, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico

César Murguía Soto, MD

• Alcantar Vallin, Maria de la Luz, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico

Maria de la Luz Alcantar Vallin, MD

• Martínez Gallardo González, Alejandro, Hospital Civil de Guadalajara, Guadalajara, Jalisco, Mexico

Alejandro Martínez Gallardo González

• Navarro Blackaller, Guillermo, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico

Guillermo Navarro Blackaller, MD

Background

In advanced CKD the worse the hemoglobin (Hb) values, the higher the risk of major adverse kidney events (MAKE). The existing evidence regarding this relationship is scarce. We carried out a retrospective cohort in patients with advanced CKD and severe anemia, who had increases in Hb level during follow-up, we looked for the association with MAKE.

Methods

In a retrospective cohort study, we included patients with CKD G3b-G5 without dialysis and severe anemia at baseline (Hb <8.0 gr/dL). Our objectives were to analyze whether there was an association between reach Hb >10gr/dL or >12gr/dL and the risk of MAKE, defined as the start of KRT and death, also analyzed the individual components of MAKE

Results

Between 2018 and 2023, a total of 174 patients with CKD G3b-5 and severe anemia (median Hb 7.05 g/dL) were included; the age was 38.5 years, 64% were male. During follow, 32 and 11 patients elevated the Hb >10 g/dl and >12 g/dl, 88.5% used erythropoietin. Patients who achieved an Hb >10 g/dL had an associated reduction in the risk of MAKE (HR 0.46, p = 0.002), especially in reducing the risk of KRT (HR 0.463, p = 0.002), but not for mortality (HR 0.88, p = 0.834), interestingly, use of EPO were associated with increasing this risk (HR 7.78, p = 0.03). We found no benefit in MAKE or its components in patients who achieved Hb >12 g/dL, nor in granular changes in the Hb level.

Conclusion

In our cohort of patients with advanced CKD and severe anemia, we found that those who during their follow-up increased their Hb value >10 g/dL had an association with a reduced risk of MAKE, mainly due to the KRT component.