- Anemia presence and severity are tied to increased risks for incident dialysis in patients with non-dialysis dependent (NDD) severe chronic kidney disease (CKD).
- Data also showed higher risks for acute hospitalization, death, and major adverse cardiovascular events (MACE).
Why this matters
- Current clinical practice guidelines focus on less-intensive anemia therapy in this setting.
- Danish population study of 16,972 unique patients with severe CKD (estimated glomerular filtration rate 2) contributing 28,510 anemia patient profiles.
- Most cases of anemia (87.4%) occurred in NDD-CKD.
- Funding: AstraZeneca.
- Anemia status:
- No anemia, 14%.
- Grade 1 anemia, 35% (hemoglobin [Hg] 10-12/13 g/dL in women/men).
- Grade 2 anemia, 44% (8-10 g/dL).
- Grade 3+ anemia, 17% (
- NDD-CKD: all risks rose with anemia severity. With presence of grade 3+ vs no anemia (aHR, 95% CI):
- Incident dialysis: 1.91 (1.61-2.26).
- Acute hospitalization: 1.74 (1.57-1.93).
- All-cause mortality: 1.82 (1.70-1.94).
- MACE: 1.14 (1.02-1.26), particularly heart failure (aHR=1.24; 95% CI, 1.09-1.41).
- A similar pattern emerged in dialysis-dependent patients. With grade 3+ vs no anemia (aHR, 95% CI):
- Acute hospitalization: 1.51 (1.20-1.90).
- All-cause mortality: 1.91 (1.50-2.43).
- Finding for MACE limited by patient number.
- Effect was not significantly modified by age or diabetes.
- Observational design.
- Potential testing bias.