Exploring the Relationship Between Hemoglobin Levels and Clinical Outcomes in Anemic Dialysis-Dependent Chronic Kidney Disease Patients
Author(s)
GAUTAM SAHU, MS, PhD1, Pramil Tiwari, PhD1, pooja arora, PhD2, Sanjay D'cruz, MD, DNB, DM, (Nephrology), MNAMS, FISN, FRCP3, Anita Tahlan, MD, DNB, DM, MAMS4.
1Department of Pharmacy Practice, National Institute of Pharmaceutical Education Research, NIPER, Mohali Punjab, India, Mohali, India, 2Department of Pharmacoinformatic, National Institute of Pharmaceutical Education Research, NIPER, Mohali Punjab, India, Mohali, India, 3Department of Medicine, Government Medical College and Hospital, GMCH, Chandigarh, India, Chandigarh, India, 4Department of Pathology, Government Medical College and Hospital, GMCH, Chandigarh, India, Chandigarh, India.
1Department of Pharmacy Practice, National Institute of Pharmaceutical Education Research, NIPER, Mohali Punjab, India, Mohali, India, 2Department of Pharmacoinformatic, National Institute of Pharmaceutical Education Research, NIPER, Mohali Punjab, India, Mohali, India, 3Department of Medicine, Government Medical College and Hospital, GMCH, Chandigarh, India, Chandigarh, India, 4Department of Pathology, Government Medical College and Hospital, GMCH, Chandigarh, India, Chandigarh, India.
Presentation Documents
OBJECTIVES: To assess the relationship between hemoglobin levels and clinical as well as biochemical outcomes in elderly and nonelderly anemic dialysis-dependent chronic kidney disease (DD-CKD) patients.
METHODS: This cross-sectional study, conducted at a tertiary care hospital, included 104 randomly selected participants categorized as nonelderly (≤50 years) or elderly (>50 years) and stratified by hemoglobin levels (≤8.0 g/dL, >8.1 g/dL). Data were analyzed using SPSS (version 20.0). Continuous variables were reported as medians (IQR), and categorical variables as frequencies (%). Relationships were assessed using the Generalized Linear Model (GLM), while binary and multinomial logistic regression analyzed clinical predictors and associations.
RESULTS: The study included 70 (67.30%) male and 34 (32.69%) female patients, with a mean age of 52.63 ± 13.27 years. Among non-elderly patients, the median hemoglobin reduction (≤8.0 g/dL) was 8.40 (6.70-9.20), whereas in elderly patients, it was 6.00 (5.00-9.00). Elderly patients exhibited a higher comorbidity burden (56.8%) compared to non-elderly patients (21.4%). Higher hemoglobin levels were observed in elderly known cases during 3-hour dialysis sessions compared to freshly diagnosed patients (OR = 2.687, CI: 0.421-17.163). Longer dialysis durations (13-26 months) in elderly known patients were associated with elevated levels of urea (OR = 1.064, CI: 0.915-1.236), creatinine (OR = 1.905, CI: 0.484-7.501), ferritin (OR = 1.006, CI: 0.989-1.023), and triglycerides (OR = 2.626, CI: 1.414-2.626). Conversely, shorter dialysis durations (<12 months) showed improved hemoglobin and vitamin D levels. Female patients demonstrated a higher mean eGFR (8.207, CI: 6.866-9.549) compared to males (7.595, CI: 6.621-8.568).
CONCLUSIONS: Hemoglobin levels significantly affect clinical and biochemical outcomes in anemic DD-CKD patients. Elderly patients with lower hemoglobin levels exhibited a higher comorbidity burden, while longer dialysis durations in elderly known cases were associated with elevated biochemical parameters and persistently low hemoglobin levels. Tailored anemia management strategies considering age, gender, and dialysis duration are essential.
METHODS: This cross-sectional study, conducted at a tertiary care hospital, included 104 randomly selected participants categorized as nonelderly (≤50 years) or elderly (>50 years) and stratified by hemoglobin levels (≤8.0 g/dL, >8.1 g/dL). Data were analyzed using SPSS (version 20.0). Continuous variables were reported as medians (IQR), and categorical variables as frequencies (%). Relationships were assessed using the Generalized Linear Model (GLM), while binary and multinomial logistic regression analyzed clinical predictors and associations.
RESULTS: The study included 70 (67.30%) male and 34 (32.69%) female patients, with a mean age of 52.63 ± 13.27 years. Among non-elderly patients, the median hemoglobin reduction (≤8.0 g/dL) was 8.40 (6.70-9.20), whereas in elderly patients, it was 6.00 (5.00-9.00). Elderly patients exhibited a higher comorbidity burden (56.8%) compared to non-elderly patients (21.4%). Higher hemoglobin levels were observed in elderly known cases during 3-hour dialysis sessions compared to freshly diagnosed patients (OR = 2.687, CI: 0.421-17.163). Longer dialysis durations (13-26 months) in elderly known patients were associated with elevated levels of urea (OR = 1.064, CI: 0.915-1.236), creatinine (OR = 1.905, CI: 0.484-7.501), ferritin (OR = 1.006, CI: 0.989-1.023), and triglycerides (OR = 2.626, CI: 1.414-2.626). Conversely, shorter dialysis durations (<12 months) showed improved hemoglobin and vitamin D levels. Female patients demonstrated a higher mean eGFR (8.207, CI: 6.866-9.549) compared to males (7.595, CI: 6.621-8.568).
CONCLUSIONS: Hemoglobin levels significantly affect clinical and biochemical outcomes in anemic DD-CKD patients. Elderly patients with lower hemoglobin levels exhibited a higher comorbidity burden, while longer dialysis durations in elderly known cases were associated with elevated biochemical parameters and persistently low hemoglobin levels. Tailored anemia management strategies considering age, gender, and dialysis duration are essential.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
CO15
Topic
Clinical Outcomes
Topic Subcategory
Clinical Outcomes Assessment, Clinician Reported Outcomes, Performance-based Outcomes
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Urinary/Kidney Disorders