Anemia Is a Risk Factor for Acute Kidney Injury and Long-Term Mortality in Critically Ill Patients

Abstract

Acute kidney injury (AKI) is a major health concern, because AKI is related with an increase in morbidity and mortality. Anemia is related to AKI in several clinical settings. However, the relationship between anemia and AKI and the effect of anemia on long-term mortality are unresolved in critically ill patients. A total of 2,145 patients admitted to the intensive care unit were retrospectively analyzed. We calculated a threshold value of hemoglobin associated with an increased risk of AKI and used this value to define anemia. The odds ratios (ORs) and hazard ratios for AKI and all-cause mortality were calculated after adjusting for multiple covariates. The OR of AKI increased depending on the decrease in hemoglobin level and the ideal threshold point of hemoglobin linked to increasing AKI risk was 10.5 g/dL. We categorized patients into anemia (< 10.5 g/dL) and non-anemia (≥ 10.5 g/dL) groups. The risk of AKI was higher in the anemia group than the non-anemia group and this trend remained significant irrespective of the AKI development time (early vs. late) or duration (< 3 days vs. ≥ 3 days). Both anemia and AKI increased the 10-year mortality risk and this risk prediction was significantly separated by the presence of anemia and AKI. Furthermore, the risk prediction remained consistent irrespective of the AKI severity (i.e., recovery, stage, or duration of AKI). Based on these, we urge clinicians to monitor anemia and AKI in critically ill patients.

Clinical markers to predict progression from acute to chronic kidney disease in Mesoamerican nephropathy

“…24 Anemia is a known risk factor for AKI, failed renal recovery, CKD progression, and renal-related mortality. [25][26][27][28] Decreased partial pressure of oxygen in the kidneys and oxidative stress contribute to acute tubular injury, glomerulosclerosis, and chronic tubulointerstitial damage. 28,29 Interstitial injury negatively impacts erythropoietin production, suppressing RBC production, a process perhaps underlying the low RBC counts we also observed.…”

Application of group LASSO regression based Bayesian networks in risk factors exploration and disease prediction for acute kidney injury in hospitalized patients with hematologic malignancies

“…One respective study in Korea also reports that anemia was more prevalent in HM patients than those with solid tumors (79.4% vs. 50.4%), and HM patients also shares a higher risk of AKI and long-term mortality [29].…”

Application of group LASSO regression based Bayesian networks in risk factors exploration and disease prediction for acute kidney injury in hospitalized patients with hematologic malignancies

“…These pathologic changes may contribute to the heightened susceptibility of AKI and partial even non-recovery in patients with CKD. Anemia was also a common feature in HM patients, which could be caused by reduced hematopoietic capacity of bone marrow, hemodilution, frequent blood sampling, dysfunctional iron metabolism, nutritional deficiencies, diminished red blood cell survival, and a blunted cellular response to erythropoietin et al One respective study in Korea also reported that anemia was more prevalent in HM patients than those with solid tumors (79.4% vs. 50.4%), and HM patients also shared a higher risk of AKI and long-term mortality [26].…”