Cut-off values of haemoglobin and clinical outcomes in incident peritoneal dialysis: the PDTAP study

作者：Xiao Xu, Zhikai Yang, Shaomei Li, Huayi Pei, Jinghong Zhao, Ying Zhang, Zibo Xiong, Yumei Liao, Ying Li, Qiongzhen Lin, Wenbo Hu, Yulin Li, Zhaoxia Zheng, Liping Duan, Gang Fu, Shanshan Guo, Beiru Zhang, Rui Yu, Fuyun Sun, Xiaoying Ma, Li Hao, Guiling Liu, Zhanzheng Zhao, Jing Xiao, Yulan Shen, Yong Zhang, Xuanyi Du, Tianrong Ji, Caili Wang, Lirong Deng, Yingli Yue, Shanshan Chen, Zhigang Ma, Yingping Li, Li Zuo, Huiping Zhao, Xianchao Zhang, Xuejian Wang, Yirong Liu, Xinying Gao, Xiaoli Chen, Hongyi Li, Shutong Du, Cui Zhao, Zhonggao Xu, Li Zhang, Hongyu Chen, Li Li, Lihua Wang, Yan Yan, Yingchun Ma, Yuanyuan Wei, Jingwei Zhou, Yan Li, Yingdong Zheng, Jinwei Wang, Ming‐Hui Zhao, Jie Dong, the PDTAP working group · 发表于：Nephrology Dialysis Transplantation · 年份：2023 · DOI：10.1093/ndt/gfad166 · 被引用次数：9 · 研究领域：Dialysis and Renal Disease Management、Erythropoietin and Anemia Treatment、Chronic Kidney Disease and Diabetes

BACKGROUND: To explore the cut-off values of haemoglobin (Hb) on adverse clinical outcomes in incident peritoneal dialysis (PD) patients based on a national-level database. METHODS: The observational cohort study was from the Peritoneal Dialysis Telemedicine-assisted Platform (PDTAP) dataset. The primary outcomes were all-cause mortality, major adverse cardiovascular events (MACE) and modified MACE (MACE+). The secondary outcomes were the occurrences of hospitalization, first-episode peritonitis and permanent transfer to haemodialysis (HD). RESULTS: A total of 2591 PD patients were enrolled between June 2016 and April 2019 and followed up until December 2020. Baseline and time-averaged Hb <100 g/l were associated with all-cause mortality, MACE, MACE+ and hospitalizations. After multivariable adjustments, only time-averaged Hb <100 g/l significantly predicted a higher risk for all-cause mortality {hazard ratio [HR] 1.83 [95% confidence interval (CI) 1.19-281], P = .006}, MACE [HR 1.99 (95% CI 1.16-3.40), P = .012] and MACE+ [HR 1.77 (95% CI 1.15-2.73), P = .010] in the total cohort. No associations between Hb and hospitalizations, transfer to HD and first-episode peritonitis were observed. Among patients with Hb ≥100 g/l at baseline, younger age, female, use of iron supplementation, lower values of serum albumin and renal Kt/V independently predicted the incidence of Hb <100 g/l during the follow-up. CONCLUSION: This study provided real-world evidence on the cut-off value of H...