Observational studyClinical and experimental nephrology2025
Association between hemoglobin level and mortality in patients undergoing maintenance hemodialysis: a nationwide dialysis registry in Japan.
Observational study in Clinical and experimental nephrology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Association between hemoglobin variability and mortality in hemodialysis patients: a retrospective cohort study.Frontiers in medicine · 2026Article
- Baseline predictors of in-hospital mortality among patients with chronic kidney disease admitted to the emergency department.World journal of nephrology · 2025Article
- Prognostic implications of systemic immune-inflammation index and systemic inflammation response index in hemodialysis patients.BMC nephrology · 2025Article
- Association between inflammatory markers and mortality in hemodialysis patients.Jornal brasileiro de nefrologiaArticle
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Authors and funding
10 authors.
Funding
Abstract
backgroundThe optimal hemoglobin (Hb) range in patients undergoing hemodialysis remains controversial. We aimed to investigate the association between Hb levels and mortality in patients undergoing hemodialysis and explore the potential factors modifying this association.
methodsThis observational study utilized a nationwide database from the Japanese Renal Data Registry spanning from 2019 to 2021. This study included 265,779 patients undergoing hemodialysis thrice a week. The association between Hb levels and all-cause and cause-specific mortality was investigated using Cox regression analysis. The nonlinear relationship between Hb levels and outcomes was investigated using restricted cubic spline analysis.
resultsDuring a median follow-up period of 24 months, 45,734 patients died. Compared to the reference Hb category of 10-10.9 g/dL, the risk of all-cause mortality was higher in the Hb categories of < 9.0, 9.0-9.9, and ≥ 13 g/dL with adjusted hazard ratios (95% confidence intervals) of 1.24 (1.20-1.29), 1.09 (1.06-1.12), and 1.19 (1.14-1.25), respectively. Restricted cubic spline analysis also showed a U-shaped relationship between Hb level and mortality. The subgroup analysis indicated that the Hb category of 12.0-12.9 g/dL was associated with increased mortality risk in patients with a dialysis vintage of ≥ 10 years and those with a history of cerebral infarction.
conclusionHb levels of < 10.0 and ≥ 13.0 g/dL were significantly associated with an increased mortality risk compared to an Hb level of 10.0-10.9 g/dL in patients undergoing hemodialysis.
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