Korean J Intern Med.  2014 May;29(3):341-351. 10.3904/kjim.2014.29.3.341.

A mild decrease of renal function is related to increased hemoglobin level during 5-year follow-up period

• Shin N
• Kim H
• Kim HJ
• Han M
• Lee S
• Jo H
• Hyuk H
• Chin HJ

• KMID: 1792060
• DOI: http://doi.org/10.3904/kjim.2014.29.3.341

Abstract

BACKGROUND/AIMS
We analyzed chronological changes in hemoglobin according to renal function changes over a 5-year follow-up period.
METHODS
We enrolled 5,266 adults with a glomerular filtration rate (GFR) > or = 60 mL/min/1.73 m2 at an initial examination at a routine health check-up; a follow-up examination was conducted 5 years later. We categorized the subjects according to GFR ratio (groups 1, 2, and 3, defined as GFRratio > or = 1.00, 0.75 to 0.99, and < 0.75, respectively).
RESULTS
The mean hemoglobin level in subjects with a GFR of 60 to 74 was higher than in those with a GFR of 75 to 89 or > or = 90 mL/min/1.73 m2 at the initial examination (all p < 0.001). Among females and males, the frequencies of increased hemoglobin were 46.8% and 40.6% in the GFRratio group 1, 52.4% and 46.1% in group 2, and 59.6% and 52.5% in group 3 over the 5-year period, respectively (all p < 0.001). With multiple logistic regression, group 3 showed 1.594-fold (95% confidence interval [CI], 1.127 to 2.225) and 1.353-fold (95% CI, 1.000 to 1.830) higher likelihoods of increased hemoglobin over the 5-year follow-up period in females and males, respectively. The estimated difference in hemoglobin level was highest in group 3 in both genders. These findings were more evident in subgroups without metabolic syndrome, diabetes mellitus, hypertension, or GFR less than 90 mL/min/1.73 m2.
CONCLUSIONS
Among a population with GFR > or = 60 mL/min/1.73 m2, a mild decrease in GFR over a 5-year follow-up period was associated with an increase in hemoglobin levels.

Keyword

Chronic kidney failure; Hemoglobins; Erythropoiesis

MeSH Terms

Adult
Aged
Biological Markers/blood
Chi-Square Distribution
Disease Progression
Female
Follow-Up Studies
*Glomerular Filtration Rate
Hemoglobins/*metabolism
Humans
Kidney/*physiopathology
Kidney Diseases/blood/diagnosis/*physiopathology
Logistic Models
Male
Middle Aged
Multivariate Analysis
Republic of Korea
Time Factors
Up-Regulation
Biological Markers
Hemoglobins