Association between hemoglobin level and mortality in patients undergoing maintenance hemodialysis: a nationwide dialysis registry in Japan.

IF 2.2 4区医学 Q2 UROLOGY & NEPHROLOGY

Clinical and Experimental Nephrology Pub Date : 2025-02-11 DOI:10.1007/s10157-025-02632-9

Takaaki Kosugi, Takeshi Hasegawa, Takahiro Imaizumi, Hiroki Nishiwaki, Hirokazu Honda, Yasuhiko Ito, Kazuhiko Tsuruya, Masanori Abe, Norio Hanafusa, Takahiro Kuragano

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引用次数: 0

Abstract

Background: The optimal hemoglobin (Hb) range in patients undergoing hemodialysis remains controversial. We aimed to investigate the association between Hb levels and mortality in patients undergoing hemodialysis and explore the potential factors modifying this association.

Methods: This observational study utilized a nationwide database from the Japanese Renal Data Registry spanning from 2019 to 2021. This study included 265,779 patients undergoing hemodialysis thrice a week. The association between Hb levels and all-cause and cause-specific mortality was investigated using Cox regression analysis. The nonlinear relationship between Hb levels and outcomes was investigated using restricted cubic spline analysis.

Results: During a median follow-up period of 24 months, 45,734 patients died. Compared to the reference Hb category of 10-10.9 g/dL, the risk of all-cause mortality was higher in the Hb categories of < 9.0, 9.0-9.9, and ≥ 13 g/dL with adjusted hazard ratios (95% confidence intervals) of 1.24 (1.20-1.29), 1.09 (1.06-1.12), and 1.19 (1.14-1.25), respectively. Restricted cubic spline analysis also showed a U-shaped relationship between Hb level and mortality. The subgroup analysis indicated that the Hb category of 12.0-12.9 g/dL was associated with increased mortality risk in patients with a dialysis vintage of ≥ 10 years and those with a history of cerebral infarction.

Conclusion: Hb levels of < 10.0 and ≥ 13.0 g/dL were significantly associated with an increased mortality risk compared to an Hb level of 10.0-10.9 g/dL in patients undergoing hemodialysis.

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来源期刊

Clinical and Experimental Nephrology UROLOGY & NEPHROLOGY-

CiteScore

4.10

自引率

4.30%

发文量

135

审稿时长

4-8 weeks

期刊介绍： Clinical and Experimental Nephrology is a peer-reviewed monthly journal, officially published by the Japanese Society of Nephrology (JSN) to provide an international forum for the discussion of research and issues relating to the study of nephrology. Out of respect for the founders of the JSN, the title of this journal uses the term “nephrology,” a word created and brought into use with the establishment of the JSN (Japanese Journal of Nephrology, Vol. 2, No. 1, 1960). The journal publishes articles on all aspects of nephrology, including basic, experimental, and clinical research, so as to share the latest research findings and ideas not only with members of the JSN, but with all researchers who wish to contribute to a better understanding of recent advances in nephrology. The journal is unique in that it introduces to an international readership original reports from Japan and also the clinical standards discussed and agreed by JSN.