Dataset Information

Regional Variation in Hemoglobin Distribution Among Individuals With CKD: the ISN International Network of CKD Cohorts.

ABSTRACT:

Introduction

Despite recognized geographic and sex-based differences in hemoglobin in the general population, these factors are typically ignored in patients with chronic kidney disease (CKD) in whom a single therapeutic range for hemoglobin is recommended. We sought to compare the distribution of hemoglobin across international nondialysis CKD populations and evaluate predictors of hemoglobin.

Methods

In this cross-sectional study, hemoglobin distribution was evaluated in each cohort overall and stratified by sex and estimated glomerular filtration rate (eGFR). Relationships between candidate predictors and hemoglobin were assessed from linear regression models in each cohort. Estimates were subsequently pooled in a random effects model.

Results

A total of 58,613 participants from 21 adult cohorts (median eGFR range of 17-49 ml/min) and 3 pediatric cohorts (median eGFR range of 26-45 ml/min) were included with broad geographic representation. Hemoglobin values varied substantially among the cohorts, overall and within eGFR categories, with particularly low mean hemoglobin observed in women from Asian and African cohorts. Across the eGFR range, women had a lower hemoglobin compared to men, even at an eGFR of 15 ml/min (mean difference 5.3 g/l, 95% confidence interval [CI] 3.7-6.9). Lower eGFR, female sex, older age, lower body mass index, and diabetic kidney disease were all independent predictors of a lower hemoglobin value; however, this only explained a minority of variance (R² 7%-44% across cohorts).

Conclusion

There are substantial regional differences in hemoglobin distribution among individuals with CKD, and the majority of variance is unexplained by demographics, eGFR, or comorbidities. These findings call for a renewed interest in improving our understanding of hemoglobin determinants in specific CKD populations.

SUBMITTER: Canney M

PROVIDER: S-EPMC10577366 | biostudies-literature | 2023 Oct

REPOSITORIES: biostudies-literature

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Publications

Regional Variation in Hemoglobin Distribution Among Individuals With CKD: the ISN International Network of CKD Cohorts.

Canney Mark M Induruwage Dilshani D Tang Mila M Alencar de Pinho Natalia N Er Lee L Zhao Yinshan Y Djurdjev Ognjenka O Ahn Yo Han YH Behnisch Rouven R Calice-Silva Viviane V Chesnaye Nicholas C NC de Borst Martin H MH Dember Laura M LM Dionne Janis J Ebert Natalie N Eder Susanne S Fenton Anthony A Fukagawa Masafumi M Furth Susan L SL Hoy Wendy E WE Imaizumi Takahiro T Jager Kitty J KJ Jha Vivekanand V Kang Hee Gyung HG Kitiyakara Chagriya C Mayer Gert G Oh Kook-Hwan KH Onu Ugochi U Pecoits-Filho Roberto R Reichel Helmut H Richards Anna A Schaefer Franz F Schaeffner Elke E Scheppach Johannes B JB Sola Laura L Ulasi Ifeoma I Wang Jinwei J Yadav Ashok K AK Zhang Jianzhen J Feldman Harold I HI Taal Maarten W MW Stengel Bénédicte B Levin Adeera A

Kidney international reports 20230812 10

<h4>Introduction</h4>Despite recognized geographic and sex-based differences in hemoglobin in the general population, these factors are typically ignored in patients with chronic kidney disease (CKD) in whom a single therapeutic range for hemoglobin is recommended. We sought to compare the distribution of hemoglobin across international nondialysis CKD populations and evaluate predictors of hemoglobin.<h4>Methods</h4>In this cross-sectional study, hemoglobin distribution was evaluated in each co ...[more]

PMID: 37850014

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Dataset Information

Regional Variation in Hemoglobin Distribution Among Individuals With CKD: the ISN International Network of CKD Cohorts.

Introduction

Methods

Results

Conclusion

Publications

Regional Variation in Hemoglobin Distribution Among Individuals With CKD: the ISN International Network of CKD Cohorts.

Similar Datasets

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