Anemia as a risk factor for all-cause mortality: obscure synergic effect of chronic kidney disease

作者：Sato Yuji^*; Fujimoto Shouichi; Konta Tsuneo; Iseki Kunitoshi; Moriyama Toshiki; Yamagata Kunihiro; Tsuruya Kazuhiko; Narita Ichiei; Kondo Masahide; Kasahara Masato; Shibagaki Yugo; Asahi Koichi; Watanabe Tsuyoshi

来源：Clinical and Experimental Nephrology, 2018, 22(2): 388-394.

DOI：10.1007/s10157-017-1468-8

• Anemia
• All-cause mortality
• Chronic kidney disease
• Propensity score

Anemia is common in chronic kidney disease (CKD) and may be associated with mortality in CKD patients. However, few studies have examined this relationship in Asian populations.
A total of 62,931 Japanese people (age 64.0 +/- 8.0 years; men 38.5%) were followed up from 2008 to 2012. Participants were divided into six groups in accordance with their estimated glomerular filtration rate (eGFR) (< 45, 45-59, ae60 mL/min/1.73 m(2)) and by hemoglobin levels (13.0 g/dL for men; 12.0 g/dL for women). Hazard ratio and confidence interval (CI) for mortality with a combination of eGFR and anemia were calculated. After matching using propensity score (PS) for anemia, survival analysis between anemic and non-anemic people, independent from some variables, including eGFR, was performed.
A total of 828 (1.3%) participants died (non-anemic vs. anemic, 1.2 vs. 2.3%, p < 0.01). Multivariable Cox analysis showed that, independent of eGFR levels, anemic people had significantly higher mortality. Anemic people were found to have significantly poorer survival than non-anemic people as per a log-rank test (p < 0.01) for the PS-matching cohort. Further stratified logistic analysis using PS in the overall cohort odds ratio (95% CI) showed 2.25 (1.89-2.67) with p < 0.01.
The results of the present study showed that anemia was an independent risk factor of all-cause mortality.

• 出版日期2018-4