Maria Majernikova1,2, Jaroslav Rosenberger3,4,5,6, Lucia Prihodova4, Daniele Marcelli7, Robert Roland3,6, Johan W Groothoff8, Jitse P van Dijk4,8. 1. Nephrology and Dialysis Centre, Fresenius Medical Care - Dialysis Services Slovakia, Tr. SNP 1, 040 11, Kosice, Slovakia. mamajern@gmail.com. 2. Faculty of Medicine, Graduate School Kosice Institute for Society and Health, Safarik University, Kosice, Slovakia. mamajern@gmail.com. 3. Nephrology and Dialysis Centre, Fresenius Medical Care - Dialysis Services Slovakia, Tr. SNP 1, 040 11, Kosice, Slovakia. 4. Faculty of Medicine, Graduate School Kosice Institute for Society and Health, Safarik University, Kosice, Slovakia. 5. Department of Social Medicine, Faculty of Medicine, Institute of Public Health, Safarik University, Kosice, Slovakia. 6. Transplantation Department of the 1st Surgery Clinic, Faculty of Medicine, Safarik University, University Hospital, Kosice, Slovakia. 7. Medical Board Fresenius Medical Care, Bad Homburg, Germany. 8. Department of Community and Occupational Health, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.
Abstract
PURPOSE: Anemia is a predictor of mortality and of self-rated health (SRH). However, studies on the relationship between SRH and changes in hemoglobin (Hb) value over time stratified by chronic kidney disease (CKD) stages are lacking. The aim is to explore whether a change in Hb-value over time associates with SRH at up to 8-year follow-up, stratified for CKD stages. METHODS: A prospective study with a baseline measurement between the 3rd and 12th month after KT was performed on 337 consecutive patients. Demographic and clinical data were retrieved from medical records. CKD stages were estimated using the CKD-EPI formula and divided into two groups: CKD1-2 and CKD3-5. Generalized estimating equations (GEE) were performed to identify associations of SRH at follow-up in both CKD groups. RESULTS: Male gender, new-onset diabetes mellitus after KT (NODAT), a decrease in estimated glomerular filtration rate (eGFR) and Hb-value over time contributed significantly to the GEE model on SRH at follow-up in CKD1-2. For SRH at follow-up in CKD3-5, older age, male gender and chronic renal allograft dysfunction (CRAD) contributed significantly to the GEE model. CONCLUSIONS: At up to 8-year follow-up, male gender, NODAT, a decrease in eGFR and Hb-value over time are associated with poorer SRH in CKD1-2. In such patients, we suggest monitoring slight deteriorations in eGFR and Hb-values. In CKD3-5, higher age, male gender and higher presence of CRAD are associated with poorer SRH at up to 8-year follow-up. In these patients, adequate treatment would slow down CRAD progression.
PURPOSE:Anemia is a predictor of mortality and of self-rated health (SRH). However, studies on the relationship between SRH and changes in hemoglobin (Hb) value over time stratified by chronic kidney disease (CKD) stages are lacking. The aim is to explore whether a change in Hb-value over time associates with SRH at up to 8-year follow-up, stratified for CKD stages. METHODS: A prospective study with a baseline measurement between the 3rd and 12th month after KT was performed on 337 consecutive patients. Demographic and clinical data were retrieved from medical records. CKD stages were estimated using the CKD-EPI formula and divided into two groups: CKD1-2 and CKD3-5. Generalized estimating equations (GEE) were performed to identify associations of SRH at follow-up in both CKD groups. RESULTS: Male gender, new-onset diabetes mellitus after KT (NODAT), a decrease in estimated glomerular filtration rate (eGFR) and Hb-value over time contributed significantly to the GEE model on SRH at follow-up in CKD1-2. For SRH at follow-up in CKD3-5, older age, male gender and chronic renal allograft dysfunction (CRAD) contributed significantly to the GEE model. CONCLUSIONS: At up to 8-year follow-up, male gender, NODAT, a decrease in eGFR and Hb-value over time are associated with poorer SRH in CKD1-2. In such patients, we suggest monitoring slight deteriorations in eGFR and Hb-values. In CKD3-5, higher age, male gender and higher presence of CRAD are associated with poorer SRH at up to 8-year follow-up. In these patients, adequate treatment would slow down CRAD progression.
Authors: Alan E Hubbard; Jennifer Ahern; Nancy L Fleischer; Mark Van der Laan; Sheri A Lippman; Nicholas Jewell; Tim Bruckner; William A Satariano Journal: Epidemiology Date: 2010-07 Impact factor: 4.822
Authors: Miklos Zsolt Molnar; Istvan Mucsi; Iain C Macdougall; James E Marsh; Magdi Yaqoob; John Main; Aisling E Courtney; Damien Fogarty; Ashraf Mikhail; Gabriel Choukroun; Colin D Short; Adrian Covic; David J Goldsmith Journal: Nephron Clin Pract Date: 2010-08-06
Authors: B Sis; M Mengel; M Haas; R B Colvin; P F Halloran; L C Racusen; K Solez; W M Baldwin; E R Bracamonte; V Broecker; F Cosio; A J Demetris; C Drachenberg; G Einecke; J Gloor; D Glotz; E Kraus; C Legendre; H Liapis; R B Mannon; B J Nankivell; V Nickeleit; J C Papadimitriou; P Randhawa; H Regele; K Renaudin; E R Rodriguez; D Seron; S Seshan; M Suthanthiran; B A Wasowska; A Zachary; A Zeevi Journal: Am J Transplant Date: 2010-01-29 Impact factor: 8.086