Do hemoglobin levels affect the progression of chronic kidney disease in patients with stage 3-4 chronic kidney disease?
Ali Riza Caliskan1, Yasin Sahinturk2, Aygul Ozdemir3, Metin Sarikaya4
1Inonu University, Faculty of Medicine Department of Gastroenterology, Malatya, Turkey
2University of Health Sciences Antalya Training and Research Hospital, Department of Internal Medicine, Antalya, Turkey
3Dinar Public Hospital, Department of Internal Medicine, Afyonkarahisar, Turkey
4University of Health Sciences Antalya Training and Research Hospital, Department of Nephrology, Antalya, Turkey
Aim: We aimed in our study to evaluate the effect of anemia on renal progression in patients with stage 3-4 CKD.
Material and Methods: A total of 88 patients, 44 females, and 44 males, were followed up in a pre-dialysis outpatient clinic with a diagnosis of stage 3-4 CKD. Forty-four of these patients had hemoglobin (HGB) value above 12 g/dL, whereas 44 of them had a value between 10-12 g/dL. We accepted the first group as normal and the second group as mild anemia. We followed up the mild anemia group without Erythropoietin (EPO) treatment. Glomerular filtration rate (GFR) values were calculated with BUN, creatinine, hemoglobin, albumin and uric acid levels that had been measured in four months periods. GFR values were calculated using the MDRD formula. The follow-up duration of the two groups was twelve months.
Results: Initial, fourth, eighth and twelfth months GFR values of the patients were calculated. There was no significant difference (F=1.242, p>0.05) between the GFR values of first, fourth, eighth, and twelfth months controls. GFR values measured at four different times were similar. Also, the GFR values showed no difference between the HGB groups (F=1.892, p>0.05). HGB levels did not affect GFR values measured at different times.
Conclusion: It is thought that in stage 3-4 CKD, maintenance of-HGB level at 10-12 g/dL or above 12 g/dL had a similar effect on renal progression. During the follow-up of CKD, HGB level above 10 g/dL is sufficient for controlling the progression of CKD.
Keywords: Renal Anemia; Progression of Chronic Kidney Disease; Erythropoietin.