ArticleAmerican journal of nephrology2017
Pre-End-Stage Renal Disease Hemoglobin Variability Predicts Post-End-Stage Renal Disease Mortality in Patients Transitioning to Dialysis.
Article in American journal of nephrology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Nondialytic Care vs Dialysis Transition on Hospitalization: Outcomes in Veterans With Advanced Chronic Kidney Disease.Mayo Clinic proceedings · 2026Article
- Hemoglobin variability predicts mortality in acute kidney injury patients undergoing continuous renal replacement therapy: a multi-database cohort study.Renal failure · 2025Article
- Infectious Risk and Variability of Hemoglobin Level in Patients Undergoing Hemodialysis.Kidney international reports · 2023Article
- Association of dyskalemias with short-term health care utilization in patients with advanced CKD.Journal of managed care & specialty pharmacy · 2021Article
- Factors affecting pre-end-stage kidney disease haemoglobin control and outcomes following dialysis initiation: a nationwide study.Clinical kidney journal · 2021Article
- Predialysis Potassium Variability and Postdialysis Mortality in Patients With Advanced CKD.Kidney international reports · 2021Article
- Potassium Trajectories prior to Dialysis and Mortality following Dialysis Initiation in Patients with Advanced CKD.Nephron · 2021Article
- Time-averaged hemoglobin values, not hemoglobin cycling, have an impact on outcomes in pediatric dialysis patients.Pediatric nephrology (Berlin, Germany) · 2018Article
Corrections and comments
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Authors and funding
11 authors.
Funding
Abstract
backgroundHemoglobin variability (Hb-var) has been associated with increased mortality both in non-dialysis dependent chronic kidney disease (NDD-CKD) and end-stage renal disease (ESRD) patients. However, the impact of Hb-var in advanced NDD-CKD on outcomes after dialysis initiation remains unknown.
methodsAmong 11,872 US veterans with advanced NDD-CKD transitioning to dialysis between October 2007 through September 2011, we assessed Hb-var calculated from the residual SD of at least 3 Hb values during the last 6 months before dialysis initiation (prelude period) using within-subject linear regression models, and stratified into quartiles. Outcomes included post-transition all-cause, cardiovascular, and infection-related mortality, assessed in Cox proportional hazards models and adjusted for demographics, comorbidities, length of hospitalization, medications, estimated glomerular filtration rate (eGFR), type of vascular access, Hb parameters (baseline Hb [i.e., intercept] and change in Hb [i.e., slope]), and number of Hb measurements.
resultsHigher prelude Hb-var was associated with use of iron and antiplatelet agents, tunneled dialysis catheter use, higher levels of baseline Hb, change in Hb, eGFR, and serum ferritin. After multivariable adjustment, higher prelude Hb-var was associated with higher post-ESRD all-cause and infection-related mortality, but not cardiovascular mortality (adjusted hazard ratios [95% CI] for the highest [vs. lowest] quartile of Hb-var, 1.10 [1.02-1.19], 1.28 [0.93-1.75], and 0.93 [0.79-1.10], respectively).
conclusionsHigh pre-ESRD Hb-var is associated with higher mortality, particularly from infectious causes rather than cardiovascular causes. Further research is required to clarify the underlying mechanisms and true causal nature of the observed association.
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