Haemoglobin levels predict outcomes in nondialysis CKD

In patients with stage 3–5 nondialysis chronic kidney disease (ND-CKD), anaemia appears to worsen health-related quality of life (HRQoL), mortality, and disease progression, a recent study has found.

The study included 2,121 ND-CKD patients (mean age, 68±13 years; 52 percent male) who were divided into three groups according to haemoglobin (Hgb) levels: <10 (n=267), 10-12 (n=843), and >12 (n=947) g/dL. Study outcomes were HRQoL, physical activity, CKD progression, and mortality.

HRQoL was measured using the Kidney Disease Quality of Life 36 (KDQOL-36), and scores were worse in patients with severe anaemia (Hgb <10 g/dL) compared to those with Hgb >10 g/dL. This finding was consistent across the different domains and subdomains of KDQOL-36. Notably, even those with only mild/moderate anaemia (Hgb 10–12 g/dL) showed impaired HRQoL.

Moreover, adjusted spline regression analysis showed that lower Hgb levels significantly decreased the likelihood of a patient being physically active (10.5 vs 12 g/dL: adjusted odds ratio, 0.63, 95 percent confidence interval [CI], 0.42–0.94).

Similarly, lower Hgb (<10 vs >12 g/dL) significantly increased the risk of CKD progression (adjusted hazard ratio [HR], 1.78, 95 percent CI, 1.29–2.47) and death (adjusted HR, 3.13, 95 percent CI, 2.11–4.65). Physical inactivity was likewise a significant risk factor for CKD progression and death.

“Our findings help inform the design of future studies aimed at understanding the effects of anaemia therapies in CKD patients and how anaemia correction may impact improvements in well-being and clinical outcomes,” the researchers said.