title: Association of Estimated Glomerular Filtration Rate with Hemoglobin Level in Korean Adults: The 2010-2012 Korea National Health and Nutrition Examination Survey.
abstract: Little is known about anemia in patients with early renal dysfunction. We aimed to investigate the association of hemoglobin level and anemia prevalence with estimated glomerular filtration rate (eGFR) decline using a nation-wide representative sample of the adult Korean population.
  
  
  
  In total, 17,373 participants (7,296 men; weighted n = 18,330,187; mean age, 44.2±0.3 years; 9,886 women, weighted n = 18,317,454; mean age, 46.9±0.3 years) were included. eGFR was divided into 5 groups: Group 1, ≥105; Group 2, 90-104; 75-89; Group 4, 60-74; and Group 5, <60 mL/min/1.73m2.
  
  
  
  The weighted anemia prevalence rates were 2.6% in men and 12.8% in women. In men, the weighted hemoglobin level increased with a decrease in eGFR; this value peaked at an eGFR of 60-89 mL/min/1.73m2 and decreased thereafter at an eGFR of <60 mL/min/1.73m2 (15.19±0.03, 15.35±0.03, 15.53±0.03, 15.52±0.06, and 14.90±0.12 g/dL from Groups 1 to 5) after adjustment for age, college graduation, cancer history, current smoking, waist circumference, serum cholesterol level, serum triglyceride level, and diastolic blood pressure. In women, the weighted hemoglobin level increased with a decrease in eGFR; this value peaked with an eGFR of 75-89 mL/min/1.73m2 and decreased thereafter (12.90±0.03, 13.08±0.02, 13.20±0.04, 13.14±0.05, and 12.47±0.11 g/dL from Groups 1 to 5) after adjustment for menstruation, pregnancy, estrogen replacement, and the above-mentioned variables. In both sexes, the weighted prevalence of anemia with an eGFR of 60-104 mL/min/1.73m2 was significantly lower than that with an eGFR of ≥105 mL/min/1.73m2 (men, 3.2±0.4%, 1.9±0.3%, 1.8±0.3%, 2.0±0.9%, and 18.1±3.1%; women, 14.0±0.8%, 11.2±0.7%, 10.5±1.0%, 13.2±1.6%, and 32.3±3.2% from Groups 1 to 5).
  
  
  
  We noted a compensatory increase in the hemoglobin level with a minor decline in kidney function (in the range of eGFR ≥60 mL/min/1.73m2) prior to a marked decrease in hemoglobin level with severe renal dysfunction.
authors.affiliation: Department of Internal Medicine, Inje University Ilsan-Paik Hospital, Goyang, Korea.
authors.forename: Sang Youb
authors.initials: SY
authors.lastname: Han
authors.affiliation: Department of Internal Medicine, Inje University Ilsan-Paik Hospital, Goyang, Korea.
authors.forename: Se Won
authors.initials: SW
authors.lastname: Oh
authors.affiliation: Department of Internal Medicine, Inje University Ilsan-Paik Hospital, Goyang, Korea.
authors.forename: Jae Won
authors.initials: JW
authors.lastname: Hong
authors.affiliation: Department of Internal Medicine, Inje University Ilsan-Paik Hospital, Goyang, Korea.
authors.forename: Seong Yoon
authors.initials: SY
authors.lastname: Yi
authors.affiliation: Department of Internal Medicine, Inje University Ilsan-Paik Hospital, Goyang, Korea.
authors.forename: Jung Hyun
authors.initials: JH
authors.lastname: Noh
authors.affiliation: Department of Internal Medicine, Inje University Ilsan-Paik Hospital, Goyang, Korea.
authors.forename: Hye Ran
authors.initials: HR
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Inje University Ilsan-Paik Hospital, Goyang, Korea.
authors.forename: Dong-Jun
authors.initials: DJ
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000740:Anemia / Q000097:blood / Q000453:epidemiology* / Q000503:physiopathology; D018798:Anemia, Iron-Deficiency / Q000097:blood / Q000453:epidemiology / Q000503:physiopathology; D005260:Female; D005919:Glomerular Filtration Rate; D006454:Hemoglobins / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D011247:Pregnancy; D015995:Prevalence; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000503:physiopathology; D056910:Republic of Korea / Q000453:epidemiology; D055815:Young Adult
chemical_list: D006454:Hemoglobins