ArticlePloS one2019
Low-normal hemoglobin levels and anemia are associated with increased risk of end-stage renal disease in general populations: A prospective cohort study.
Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.
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Who cites it
16 citing papers in PubMed, 2 syntheses or guidelines pooled it, 32 citations in OpenAlex.
- Is serum hemoglobin level an independent prognostic factor for IgA nephropathy?: a systematic review and meta-analysis of observational cohort studies.Renal failure · 2023Pooled it
- Risk Factors for Anemia in Patients with Chronic Renal Failure: A Systematic Review and Meta-Analysis.Ethiopian journal of health sciences · 2020Pooled it
- Attribute-based cross-classification reveals sex- and age-specific prognostic impact of anemia in ADPKD.Clinical and experimental nephrology · 2026Article
- DASH diet, Reduced Rank Regression Dietary Patterns and relations with kidney function in the CHRIS general population study.BMC nephrology · 2026Article
- Association of anemia with long-term renal prognosis in autosomal dominant polycystic kidney disease using time-series analysis.Scientific reports · 2026Article
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- Anemia and Hypoxia Impact on Chronic Kidney Disease Onset and Progression: Review and Updates.Cureus · 2023Review
- Independent risk factors of rapid glomerular filtration rate decline in patients with type 2 diabetes with preserved kidney function and normoalbuminuria: A multicenter cohort study.Journal of diabetes investigation · 2023Observational
- Development and validation of a risk nomogram model for predicting pulmonary hypertension in patients with stage 3-5 chronic kidney disease.International urology and nephrology · 2023Article
- Anemia Prevalence, Type, and Associated Risks in a Cohort of 5.0 Million Insured Patients in the United States by Level of Kidney Function.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2023Observational
- Association between hemoglobin and chronic kidney disease progression: a secondary analysis of a prospective cohort study in Japanese patients.BMC nephrology · 2022Article
- High hemoglobin fluctuation was a protective factor for cardiovascular-related death in peritoneal dialysis (PD) patients: A retrospective analysis of 232 patients with PD.Journal of clinical laboratory analysis · 2022Article
- Nomogram prediction model for renal anaemia in IgA nephropathy patients.Open medicine (Warsaw, Poland) · 2021Article
- Prevalence of Anemia and Its Associated Factors Among Chronic Kidney Disease Patients Attending Selected Public Hospitals of Addis Ababa, Ethiopia: Institutional-Based Cross-Sectional Study.International journal of nephrology and renovascular disease · 2021Article
- Development of a Biomarker Panel to Distinguish Risk of Progressive Chronic Kidney Disease.Biomedicines · 2020Article
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Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe impact of low-normal hemoglobin (Hb) levels and anemia on the risk of end-stage renal disease (ESRD) in general populations has rarely been examined.
methods510,620 Korean adults aged 40-80 years without known chronic kidney disease (CKD) underwent health examinations during 2002-2003 and were followed-up until 2013. Incidence of ESRD was identified by hospital discharge and clinical visit records.
resultsDuring a mean follow-up of 10.5, 575 women and 1047 men were diagnosed with ESRD. Lower Hb levels were associated with an increased risk of ESRD at given severity of albuminuria and at given estimated glomerular filtration rate (eGFR). Hb 13-13.9 g/dL in men, Hb 11-11.9 g/dL in women, and trace albuminuria assessed by dipstick urinalysis were associated with more than doubled risk. The risk associated with lower Hb was stronger in older (≥60 years) than younger women. Among 349,993 participants with information on eGFR, the multivariable-adjusted HRs associated with 1 g/dL lower Hb in participants with eGFR values ≥60, 30-59, and <30 mL/min/1.73 m2 were 1.34 (95% CI, 1.17-1.54), 1.55 (1.38-1.74), and 1.75 (1.47-2.09), respectively (Pinteraction between eGFR groups = .06).
conclusionsLow-normal Hb levels and anemia are risk factors for ESRD incidence in person without CKD and for CKD progression to ESRD. Lower Hb increases the risk of ESRD through synergistic biological interactions with lower eGFR and albuminuria. The impacts of lower Hb may be stronger in older than younger women. Proper management and screening at earlier stage of Hb decline and anemia might reduce the burden of CKD.
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