Impact of Anemia and Comorbidity Burden on Disease Progression and Outcomes in Chronic Kidney Disease

Abstract

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.