Abstract: TH-PO080
Association between Hemoglobin Levels and Kidney Recovery after AKI Requiring Continuous Kidney Replacement Therapy
Session Information
- AKI: Clinical, Outcomes, and Trials - Epidemiology and Pathophysiology
October 24, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Acute Kidney Injury
- 102 AKI: Clinical, Outcomes, and Trials
Authors
- Park, Jae Yoon, Dongguk University Medical Center, Goyang, Gyeonggi, Korea (the Republic of)
- Ko, Hyun Lee, Eulji University Uijeongbu Eulji Medical Center, Uijeongbu, Gyeonggi-do, Korea (the Republic of)
- Jung, Jiyun, Dongguk University Medical Center, Goyang, Gyeonggi, Korea (the Republic of)
- Lee, Sung Woo, Eulji University Uijeongbu Eulji Medical Center, Uijeongbu, Gyeonggi-do, Korea (the Republic of)
- Kim, Yong Chul, Seoul National University Hospital, Jongno-gu, Seoul, Korea (the Republic of)
- Lim, Jeong-Hoon, Kyungpook National University Chilgok Hospital, Buk, Daegu, Korea (the Republic of)
- Paek, Jin hyuk, Keimyung University Dongsan Medical Center, Daegu, Korea (the Republic of)
- Park, Woo Yeong, Keimyung University Dongsan Medical Center, Daegu, Korea (the Republic of)
- Kim, Kipyo, Inha University, Incheon, Korea (the Republic of)
- Song, Jeongin, Dongguk University Medical Center, Goyang, Gyeonggi, Korea (the Republic of)
- Lee, Jangwook, Dongguk University Medical Center, Goyang, Gyeonggi, Korea (the Republic of)
- Shin, Sung Joon, Dongguk University Medical Center, Goyang, Gyeonggi, Korea (the Republic of)
- Macedo, Etienne, University of California San Diego, La Jolla, California, United States
Background
Anemia is a prevalent complication in patients with acute kidney injury (AKI) who require continuous kidney replacement therapy (CKRT), and it significantly contributes to the increased mortality and morbidity rates seen in these patients. Despite its significant clinical implications, there is limited evidence on the specific serum hemoglobin (Hb) thresholds that may impede, delay, or alter the course of kidney recovery in these patients.
Methods
We conducted a retrospective analysis of 2,856 patients with AKI who underwent CKRT across four university hospitals from 2006 and 2021. Hb levels were systematically recorded during CKRT, and the mean Hb level during treatment was designated as the primary exposure variable. To assess the impact of average Hb levels on the likelihood of dialysis dependence (DD) at discharge, we calculated the odds ratio (OR) while adjusting for several variables: sex, age, Charlson Comorbidity Index, hypertension history, cause of AKI (sepsis-related or other), systolic and diastolic blood pressure, white blood cell count, serum albumin, serum creatinine, APACHE II score, SOFA score, duration of CKRT, volume of transfusions received, and use of mechanical ventilation.
Results
In our cohort, 61.6% of the patients were male, with an average age of 65.4 years. The average duration of CKRT was 7.7 days, and 65.2% of patients were dialysis-dependent at hospital discharge. A U-shaped correlation between average Hb levels and DD was evident from spline curve analysis. The range between 9.1 and 10.1 g/dL was significant for the lowest risk for DD with ORs below 1.0 and a 95% confidence interval supporting this finding. Furthermore, logistic regression using continuous average Hb levels revealed that each 1 g/dL increase in average Hb was associated with a 6% reduction in the risk of DD. Also, each additional day of Hb within this range decreased the risk of DD by 6%.
Conclusion
This study indicates that average Hb levels between 9.1 and 10.1 g/dL during CKRT were associated with the lowest ORs for DD. These findings underscore the need for further research into the optimal Hb thresholds for transfusion in patients undergoing CKRT, as this may significantly influence kidney recovery outcomes.