Impact of Anemia and Comorbidity Burden on Disease Progression and Outcomes in Chronic Kidney Disease
Collince Odiwuor Ogolla, Stanslaus Musyoki, Lucy W. Karani, Phidelis MarutiABSTRACT
Background
Chronic kidney disease progression is influenced by anemia and comorbidities; however, the possibility of a real effect of these two phenomena has hardly been the subject of research.
Objective
The present study set out to evaluate the association between anemia and burden of comorbidities on CKD progression and hospitalizations over 1 year.
Methods
A retrospective study involving 120 adult CKD patients. Anemia was defined as hemoglobin < 13 g/dL in males and < 12 g/dL in females while comorbidity burden was defined by a simple comorbidity index: hypertension, diabetes, and cardiovascular disease. CKD progression was coded as a ≥ 25% decline in eGFR or stage conversion. Multivariate logistic regression identified predictors of hospitalization.
Results
Participants' mean age was 58.3 years, and 53.3% were males. Anemia was present in 67.5% of the cases, and 33.3% had two or more comorbidities. CKD progression was seen in 43.3% at 1 year; patients with anemia and two or more comorbidities showed the highest progression rate at 77.5% ( p < 0.001). Progressors had significantly lower hemoglobin and higher RDW values. Hospitalization was documented in 29.2%, and anemia independently predicted hospitalization (OR 3.4); comorbidity index ≥ 2 (OR 2.8), and RDW > 14.5% (OR 2.6). Each 1 g/dL increase in hemoglobin reduced hospitalization risk by 28% (OR 0.72).
Conclusion
Anemia and multiple comorbidities jointly increased the risk of CKD progression and hospitalization. Routine hematological parameters along with assessing comorbidities might have a role to play in early risk stratification and guiding focused interventions in CKD management.