The Association between Serum Hemoglobin and Renal Prognosis of IgA Nephropathy

Oh, Tae Ryom; Song, Su Hyun; Choi, Hong Sang; Kim, Chang Seong; Han, Seung Hyeok; Kang, Kyung Pyo; Kwon, Young Joo; Kim, Soo Wan; Kwon, Seong; Bae, Eun Hui

doi:10.3390/jcm10020363

Cited by 7 publications

(14 citation statements)

References 42 publications

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“…There was also no statistically significant interaction of hemoglobin between men and women (P interaction = 0.8543). The interaction of hemoglobin between men and women was also consistent with the findings of Oh, T R et al [24]. Unlike them, our study found a statistically significant relationship between hemoglobin and CKD progression in both male and female patients.…”

Section: Discussionsupporting

confidence: 93%

“…However, in their further subgroup analyses, reduced serum hemoglobin was an independent risk factor for IgA nephropathy progression only in women(HR = 0.875, 95%CI: 0.768-0.998, P = 0.046), while in men, the HR and 95%CI were 0.937,0.858, 1.023, respectively. There was no statistically significant interaction of serum hemoglobin between men and women (P interaction = 0.177) [24]. In our research, having a medium sample size, the multivariable-adjusted Cox proportional hazards models showed a negative association between Hb and renal composite endpoint, consistent with those two studies.…”

Section: Discussionsupporting

confidence: 88%

“…In a recent retrospective research with multivariableadjusted Cox proportional hazards models, Song et al found that Hb was negatively associated with CKD progression in 265 patients with type 2 diabetes mellitus (HR = 0.65, 95%CI: 0.48-0.88, P = 0.0055) [23]. In another retrospective cohort study that included 4326 patients with IgA nephropathy, Oh, T R et al found that baseline hemoglobin levels were also negatively associated with renal prognosis (HR = 0.871, 95%CI: 0.773-0.983, P = 0.025) [24]. However, in their further subgroup analyses, reduced serum hemoglobin was an independent risk factor for IgA nephropathy progression only in women(HR = 0.875, 95%CI: 0.768-0.998, P = 0.046), while in men, the HR and 95%CI were 0.937,0.858, 1.023, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…Hemoglobin concentration is related to the risk of cardiovascular disease and mortality in patients with and without diabetes [19][20][21]. Some studies suggest that low hemoglobin concentrations may be associated with an increased risk of poor kidney disease outcomes in people with type 2 diabetes [22,23] and IgA nephropathy [24]. However, elevated hemoglobin levels have been implicated in a higher risk of mortality and cardiovascular events [25,26] and CKD progression [27].…”

Section: Introductionmentioning

confidence: 99%

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Association between hemoglobin and chronic kidney disease progression: a secondary analysis of a prospective cohort study in Japanese patients

Pan¹,

Han

et al. 2022

BMC Nephrol

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Objective Anemia has been reported as a risk factor for chronic kidney disease (CKD) progression. However, there are still few studies examining the relationship between specific hemoglobin (Hb) levels and renal prognosis and renal function decline simultaneously. Meanwhile, the possible non-linear relationship between Hb and CKD progression also deserves further exploration. On that account, our primary goal is to explore the link of Hb on renal prognosis and renal function decline in patients with CKD. Methods This study was a secondary analysis of a prospective cohort study, which consecutively and non-selectively collected 962 participants from the research of CKD-ROUTE in Japan from November 2010 to December 2011. We used the Cox proportional-hazards and linear regression models to evaluate the independent association between baseline Hb and renal prognosis (renal composite endpoint, initiation of dialysis during follow-up or 50% decline in eGFR from baseline) and renal function decline(annual eGFR decline), respectively. A multivariate Cox proportional hazards regression analysis with cubic spline functions model and smooth curve fitting (penalized spline method) were conducted to address Hb and CKD prognosis's non-linearity. At the same time, a generalized additive model (GAM) and smooth curve fitting (penalized spline method) was conducted to explore the exact shape of the curve between Hb and renal function decline. Additionally, we did a series of sensitivity analyses to ensure the robustness of the results. Moreover, we conducted subgroup analyses. Results The mean age of the included patients was 67.35 ± 13.56 years old, and 69.65% were male. The mean baseline Hb and estimated glomerular filtration rate (eGFR) was 12.06 ± 2.21 g/dL and 33.04 ± 18.01 ml/min per 1.73 m2. The annual decline in eGFR was 2.09 mL/min/1.73 m2/year. During a median follow-up time of 33.5 months, 252(26.2%) people experienced renal composite endpoint. After adjusting covariates, the results showed that Hb was negatively associated with renal composite endpoint (HR = 0.836, 95%CI: 0.770, 0.907) and renal function decline (β = -0.436, 95%CI: -0.778, -0.093). There was also a non-linear relationship between Hb and renal composite endpoint, and the inflection point of Hb was 8.6 g/dL. The effect sizes(HR) on the left and right sides of the inflection point were 1.257 (0.841, 1.878) and 0.789 (0.715, 0.870), respectively. And the sensitive analysis demonstrated the robustness of the results. Subgroup analysis showed that Hb was more strongly associated with the renal composite endpoint in non-hypertensive, SBP < 140 mmHg, urine protein-to-creatinine ratio (UPCR) < 0.5 g/gCr, and diuretic use patients. In contrast, the weaker association was probed in hypertensive and non-diuretic use patients and the patients with SBP ≥ 140 mmHg, and UPCR ≥ 0.5 g/gCr. Conclusion This study demonstrates a negative and non-linear relationship between Hb and renal prognosis and renal function decline in Japanese CKD patients. Hb is strongly related to renal prognosis when Hb is above 8.6 g/dL.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Association between hemoglobin and chronic kidney disease progression: a secondary analysis of a prospective cohort study in Japanese patients

Pan¹,

Han

et al. 2022

BMC Nephrol

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“…Another independent risk factor we identified was female sex. Oh et al found that in IgA nephropathy, female sex was strongly associated with decreased haemoglobin [ 30 ]. Poudel et al also found a high incidence of anaemia in women with CKD [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

Nomogram prediction model for renal anaemia in IgA nephropathy patients

Wei

Wang

et al. 2021

Open Medicine

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In this study, we focused on the influencing factors of renal anaemia in patients with IgA nephropathy and constructed a nomogram model. We divided 462 patients with IgA nephropathy diagnosed by renal biopsy into anaemic and non-anaemic groups. Then, the influencing factors of renal anaemia in patients with IgA nephropathy were analysed by least absolute shrinkage and selection operator (LASSO) regression and multivariable logistic regression, and a nomogram model for predicting renal anaemia was established. Eventually, nine variables were obtained, which are easy to apply clinically. The areas under the receiver operating characteristic (ROC) curve and precision-recall (PR) curve reached 0.835 and 0.676, respectively, and the C-index reached 0.848. The calibration plot showed that the model had good discrimination, accuracy, and diagnostic efficacy. In addition, the C-index of the model following internal validation reached 0.823. Decision curve analysis suggested that the model had a certain degree of clinical significance. This new nomogram model of renal anaemia combines the basic information, laboratory findings, and renal biopsy results of patients with IgA nephropathy, providing important guidance for predicting and clinically intervening in renal anaemia.

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Hemoglobin as a prognostic marker for neurological outcomes in post-cardiac arrest patients: a meta-analysis

Hou,

Pang,

Zhao

et al. 2023

Sci Rep

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The aim of this study was to investigate the relationship between serum level of hemoglobin and neurological outcomes following cardiac arrest. Relevant studies were identified by searching electronic databases including PubMed, Web of Science, Cochrane Library, and Embase from June 2012 through April 2023. Articles were rigorously reviewed for their study inclusion and exclusion criteria. Pooled effect date was determined using the standardized mean difference (SMD) and 95% confidence intervals (CI). The Newcastle–Ottawa Scale was used to evaluate study quality. Subgroup analyses were conducted to determine confounding factors affecting patient outcomes. Study heterogeneity, sensitivity, and publication bias were also determined.This meta-analysis included 11 studies involving 2519 patients. Our results suggest that high serum level of hemoglobin may improve neurological prognosis(SMD = 0.60, 95%CI = 0.49–0.71, I2 = 10.85). The findings of this study indicate that serum level of hemoglobin may be associated with better neurological prognosis, perhaps an appropriate increase in serum haemoglobin levels can improve the neurological prognosis of patients in cardiac arrest.

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The Association between Serum Hemoglobin and Renal Prognosis of IgA Nephropathy

Cited by 7 publications

References 42 publications

Association between hemoglobin and chronic kidney disease progression: a secondary analysis of a prospective cohort study in Japanese patients

Association between hemoglobin and chronic kidney disease progression: a secondary analysis of a prospective cohort study in Japanese patients

Nomogram prediction model for renal anaemia in IgA nephropathy patients

Hemoglobin as a prognostic marker for neurological outcomes in post-cardiac arrest patients: a meta-analysis

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