Though anemia is a sign of poor renal prognosis in chronic kidney disease (CKD), hemoglobin (Hb) levels are typically higher in autosomal dominant polycystic kidney disease (ADPKD) than in other kidney diseases, and anemia has not been examined as a potential prognosticator. Thus, we investigated anemia as a factor for renal prognosis in ADPKD.
In total, 115 non-dialysis patients, 48 men and 67 women, with ADPKD were evaluated. The renal outcome of a 50% reduction in the estimated glomerular filtration rate or renal replacement therapy was examined using the Cox regression analysis and Kaplan–Meier analysis.
Patients were followed for a median of 5.5 years and 50 patients had reached the end point. The mean age of the patients at the first visit was 45.9 ± 13.3 years. The overall mean Hb was 12.90 ± 1.85 g/dL, and the mean Hb in men and women was 13.82 ± 1.72 g/dL and 12.25 ± 1.65 g/dL, respectively. Hb levels and uric protein content were statistically significant factors for poor renal prognosis, while hypertension and genetic mutations failed to reach significance. Furthermore, statistical significance was found in men with Hb < 12 g/dL and in women with Hb < 11 g/dL. Anemia had significant association with kidney disease progression in patients with ADPKD.
We found that anemia might be a factor for poor renal prognosis in ADPKD. Furthermore, a sex difference was found, wherein men with Hb < 12 g/dL and women with Hb < 11 g/dL were at risk of renal disease progression.
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We express our sincere appreciation to all the patients, collaborating physicians, and other medical staff for their important contributions to the study. We particularly want to thank Ms. Naomi Iwasa for contributing to this study by collecting the clinical data. This study was supported in part by a Grant-in-Aid for Intractable Renal Diseases Research, Research on rare and intractable diseases, Health and Labour Sciences Research Grants from the Ministry of Health, Labour and Welfare of Japan.
Conflict of interest
Toshio Mochizuki and Ken Tsuchiya received travel fees and honoraria for lectures from Otsuka Pharmaceutical Co. Toshio Mochizuki and Hiroshi Kataoka belong to an endowed department sponsored by Otsuka Pharmaceutical Co, Chugai Pharmaceutical Co, Kyowa Hakko Kirin Co, and JMS Co.
Research involving human participants and/or animals
All procedures were approved by the research ethics committee of Tokyo Women’s Medical University (No. 196B) in accordance with the 1964 Declaration of Helsinki and its later amendments, or with comparable ethical standards.
Written informed consent was obtained from all participants included in the study.
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Ushio, Y., Kataoka, H., Sato, M. et al. Association between anemia and renal prognosis in autosomal dominant polycystic kidney disease: a retrospective study. Clin Exp Nephrol (2020). https://doi.org/10.1007/s10157-020-01856-1
- Autosomal dominant polycystic kidney disease
- Kidney disease progression
- Renal replacement therapy