KMID : 0359920150340010020
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Korean Journal of Nephrology 2015 Volume.34 No. 1 p.20 ~ p.27
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Optimal hemoglobin level for anemia treatment in a cohort of hemodialysis patients
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Jung Mi-Yeon
Hwang Soon-Young Hong Yu-Ah Oh Su-Young Seo Jae-Hee Lee Young-Mo Park Sang-Won Kim Jung-Sun Wang Joon-Kwang Kim Jeong-Yup Lee Ji-Eun Ko Gang-Jee Pyo Heui-Jung Kwon Young-Joo
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Abstract
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Background: Anemia is a major risk factor that contributes to mortality in patients with chronic kidney disease. There is controversy over the optimal hemoglobin (Hb) target in these patients. This study investigated the association between Hb level and mortality in a cohort of hemodialysis (HD) patients in Korea.
Methods: This study was a multicenter prospective observational study of maintenance HD patients that was performed for 5 years in western Seoul, Korea. Three hundred and sixty-two participants were enrolled. Laboratory values and mortality
were accessed every 6 months. Repeated measures of laboratory values in each interval were averaged to obtain one semiannual mean value. The Hb values were divided into six groups: (1) Hbo9 g/dL; (2) 9 g/dLrHbo10 g/dL; (3) 10 g/dL
rHbo11 g/dL; (4) 11 g/dLrHbo12 g/dL; (5) 12 g/dLrHbo13 g/dL; and (6) HbZ13 g/dL. We analyzed the odds ratio for all-cause mortality, based on the Hb group, and adjusted for demographics and various laboratory values. Statistics were
performed with SAS, version 9.1 software (SAS Institute Inc., Cary, NC, USA).
Results: Mortality odds ratios relative to the reference group (10?11 g/dL) in the fully adjusted model were 3.61 foro9 g/dL; 3.17 for 9?10 g/dLn; 4.65 for 11?12 g/dLn; 5.50 for 12?13 g/dLn; and 2.05 forZ13 g/dL (n indicates Po0.05).
Conclusion: In this study, a Hb level of 10?11 g/dL was associated with the lowest mortality among the groups with Hb levelo13 g/dL. Larger interventional trials are warranted to determine the optimal Hb target for Korean HD patients.
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KEYWORD
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Anemia, Hemodialysis, Hemoglobin, Mortality
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