Objective To evaluate the association of baseline and time-updated hemoglobin(Hb)with end-stage kidney disease(ESKD),all-cause mortality,and cardiovascular events.Methods This study was based on the Chinese Cohort Study of Chronic Kidney Disease.A total of 3413CKD patientswith complete baseline dataand 914 CKD patients with baseline data and at least 2 follow-up records each yearfrom 39 centers between Nov.2011 and Oct.2016 were included as the research subjects.Multivariable Cox proportional hazards regression models were applied to analyze the association of baseline and time-updated Hbwith the occurrence of ESKD,cardiovascular events and all-cause mortality.ResultsAfter multivariable adjustment,both baseline(HR=1.14,95％CI 1.08-1.20)and time-updated Hb(HR=1.51,95％CI 1.35-1.70)were associated with the risk of ESKD,and the association of time-updated Hb was more significant.Only baseline Hb,not time-updated Hb,was associated with all-cause death(HR=1.14,95％CI 1.03-1.25).Baseline Hb was associated with the risk of congestive heart failure(HR=1.16,95％CI 1.02-1.33).ConclusionIn Chinese patients with stage 1-4 CKD,low baseline and time-updated Hb level is independently associated with the increased risk of ESKD.The association of anemia with congestive heart failure and all-cause mortality is only significant in single Hb evaluation,and the effects of long-term exposure need further study.
chronic kidney diseaseanemiaend stage kidney diseasecardiovascular diseaseall-cause mortalitycohort study
国家科技期刊平台
NSTL
万方数据
