title: Effect of anaemia on mortality, cardiovascular hospitalizations and end-stage renal disease among patients with chronic kidney disease.
abstract: OBJECTIVE
  To determine whether an independent association exists between anaemia and chronic kidney disease (CKD) outcomes in a quasi-incidence cohort when patients' most recent laboratory values are considered.
  
  
  METHODS
  We conducted a dynamic, retrospective cohort study among patients with incident CKD in a large health maintenance organization administrative data set. CKD was defined by two estimated glomerular filtration rates (eGFR). We measured the absolute rates for all-cause mortality, cardiovascular hospitalizations and end-stage renal disease.
  
  
  RESULTS
  Our completed cases Cox regression model followed 5885 patients with both CKD and haemoglobin measures. For patients with the most severe anaemia (haemoglobin <10.5 g/dL), we estimated an increased rate of mortality (hazard ratio (HR)=5.27, CI 4.37-6.35), cardiovascular hospitalizations (HR=2.18, CI 1.76-2.70) and end-stage renal disease (HR=5.46, CI 3.38-8.82) when compared with patients who were not anaemic; the HR reflect time-varying haemoglobins and eGFR.
  
  
  CONCLUSIONS
  Anaemia is a predictor of excess mortality, excess cardiovascular hospitalizations and excess end-stage renal disease even when the progression of CKD is considered by controlling for time-varying eGFR values.
authors.affiliation: Department of Nephrology, The Kaiser Permanente Northwest, Portland, Oregano 97227, USA.
authors.forename: Micah L
authors.initials: ML
authors.lastname: Thorp
authors.forename: Eric S
authors.initials: ES
authors.lastname: Johnson
authors.forename: Xuihai
authors.initials: X
authors.lastname: Yang
authors.forename: Amanda F
authors.initials: AF
authors.lastname: Petrik
authors.forename: Robert
authors.initials: R
authors.lastname: Platt
authors.forename: David H
authors.initials: DH
authors.lastname: Smith
mesh_terms: D000328:Adult; D000368:Aged; D000740:Anemia / Q000150:complications / Q000401:mortality*; D002318:Cardiovascular Diseases / Q000401:mortality*; D002908:Chronic Disease; D015331:Cohort Studies; D005260:Female; D005919:Glomerular Filtration Rate; D006454:Hemoglobins / Q000032:analysis; D006760:Hospitalization; D006801:Humans; D007674:Kidney Diseases / Q000401:mortality*; D007676:Kidney Failure, Chronic / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
chemical_list: D006454:Hemoglobins