A mild decrease of renal function is related to increased hemoglobin level during 5-year follow-up period.
10.3904/kjim.2014.29.3.341
- Author:
Nara SHIN
1
;
Hyunsuk KIM
;
Hyo Jin KIM
;
Miyeun HAN
;
Sunhwa LEE
;
Hyungah JO
;
Huh HYUK
;
Ho Jun CHIN
Author Information
1. Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
- Publication Type:Original Article ; Multicenter Study
- Keywords:
Chronic kidney failure;
Hemoglobins;
Erythropoiesis
- MeSH:
Adult;
Aged;
Biological Markers/blood;
Chi-Square Distribution;
Disease Progression;
Female;
Follow-Up Studies;
*Glomerular Filtration Rate;
Hemoglobins/*metabolism;
Humans;
Kidney/*physiopathology;
Kidney Diseases/blood/diagnosis/*physiopathology;
Logistic Models;
Male;
Middle Aged;
Multivariate Analysis;
Republic of Korea;
Time Factors;
Up-Regulation
- From:The Korean Journal of Internal Medicine
2014;29(3):341-351
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND/AIMS: We analyzed chronological changes in hemoglobin according to renal function changes over a 5-year follow-up period. METHODS: We enrolled 5,266 adults with a glomerular filtration rate (GFR) > or = 60 mL/min/1.73 m2 at an initial examination at a routine health check-up; a follow-up examination was conducted 5 years later. We categorized the subjects according to GFR ratio (groups 1, 2, and 3, defined as GFRratio > or = 1.00, 0.75 to 0.99, and < 0.75, respectively). RESULTS: The mean hemoglobin level in subjects with a GFR of 60 to 74 was higher than in those with a GFR of 75 to 89 or > or = 90 mL/min/1.73 m2 at the initial examination (all p < 0.001). Among females and males, the frequencies of increased hemoglobin were 46.8% and 40.6% in the GFRratio group 1, 52.4% and 46.1% in group 2, and 59.6% and 52.5% in group 3 over the 5-year period, respectively (all p < 0.001). With multiple logistic regression, group 3 showed 1.594-fold (95% confidence interval [CI], 1.127 to 2.225) and 1.353-fold (95% CI, 1.000 to 1.830) higher likelihoods of increased hemoglobin over the 5-year follow-up period in females and males, respectively. The estimated difference in hemoglobin level was highest in group 3 in both genders. These findings were more evident in subgroups without metabolic syndrome, diabetes mellitus, hypertension, or GFR less than 90 mL/min/1.73 m2. CONCLUSIONS: Among a population with GFR > or = 60 mL/min/1.73 m2, a mild decrease in GFR over a 5-year follow-up period was associated with an increase in hemoglobin levels.
