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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Hemoglobin Variability in Nondialysis Chronic Kidney Disease: Examining the Association with Mortality</title><author><name sortKey="Boudville, Neil C" sort="Boudville, Neil C" uniqKey="Boudville N" first="Neil C." last="Boudville">Neil C. Boudville</name><affiliation><nlm:aff id="N0x3dbe7e0N0x37d9ce0">School of Medicine and Pharmacology, University of Western Australia, and Department of Renal Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia;</nlm:aff></affiliation></author><author><name sortKey="Djurdjev, Ognjenka" sort="Djurdjev, Ognjenka" uniqKey="Djurdjev O" first="Ognjenka" last="Djurdjev">Ognjenka Djurdjev</name><affiliation><nlm:aff id="N0x3dbe7e0N0x37d9ce0">Department of Medicine, Division of Nephrology, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada;</nlm:aff></affiliation></author><author><name sortKey="Macdougall, Iain C" sort="Macdougall, Iain C" uniqKey="Macdougall I" first="Iain C." last="Macdougall">Iain C. Macdougall</name><affiliation><nlm:aff id="N0x3dbe7e0N0x37d9ce0">Department of Renal Medicine, King's College Hospital, London, United Kingdom;</nlm:aff></affiliation></author><author><name sortKey="De Francisco, Angel L M" sort="De Francisco, Angel L M" uniqKey="De Francisco A" first="Angel L. M." last="De Francisco">Angel L. M. De Francisco</name><affiliation><nlm:aff id="N0x3dbe7e0N0x37d9ce0">Servicio de Nefrologia, Hospital Universitario Valdecilla, Santander, Spain;</nlm:aff></affiliation></author><author><name sortKey="Deray, Gilbert" sort="Deray, Gilbert" uniqKey="Deray G" first="Gilbert" last="Deray">Gilbert Deray</name><affiliation><nlm:aff id="N0x3dbe7e0N0x37d9ce0">Department of Nephrology, Hospitalier Pitié-Salpetrière, Paris, France;</nlm:aff></affiliation></author><author><name sortKey="Besarab, Anatole" sort="Besarab, Anatole" uniqKey="Besarab A" first="Anatole" last="Besarab">Anatole Besarab</name><affiliation><nlm:aff id="N0x3dbe7e0N0x37d9ce0">Department of Medicine, Division of Nephrology and Hypertension, Henry Ford Health System, Detroit, Michigan;</nlm:aff></affiliation></author><author><name sortKey="Stevens, Paul E" sort="Stevens, Paul E" uniqKey="Stevens P" first="Paul E." last="Stevens">Paul E. Stevens</name><affiliation><nlm:aff id="N0x3dbe7e0N0x37d9ce0">Department of Renal Medicine, Kent and Canterbury Hospital, Canterbury, United Kingdom;</nlm:aff></affiliation></author><author><name sortKey="Walker, Rowan G" sort="Walker, Rowan G" uniqKey="Walker R" first="Rowan G." last="Walker">Rowan G. Walker</name><affiliation><nlm:aff id="N0x3dbe7e0N0x37d9ce0">Department of Nephrology, Royal Melbourne Hospital, Melbourne, Victoria, Australia;</nlm:aff></affiliation></author><author><name sortKey="Ure A, Pablo" sort="Ure A, Pablo" uniqKey="Ure A P" first="Pablo" last="Ure A">Pablo Ure A</name><affiliation><nlm:aff id="N0x3dbe7e0N0x37d9ce0">Service de Néphrologie Dialyse, Clinique du Landy, Saint Ouen, France;</nlm:aff></affiliation></author><author><name sortKey="I Igo, Pablo" sort="I Igo, Pablo" uniqKey="I Igo P" first="Pablo" last="I Igo">Pablo I Igo</name><affiliation><nlm:aff id="N0x3dbe7e0N0x37d9ce0">Servicio de Nefrología, Hospital Clinico Universitario “Lozano Blesa,” Zaragoza, Spain;</nlm:aff></affiliation></author><author><name sortKey="Minutolo, Roberto" sort="Minutolo, Roberto" uniqKey="Minutolo R" first="Roberto" last="Minutolo">Roberto Minutolo</name><affiliation><nlm:aff id="N0x3dbe7e0N0x37d9ce0">Department of Nephrology, Second University of Naples, Naples, Italy;</nlm:aff></affiliation></author><author><name sortKey="Haviv, Yosef S" sort="Haviv, Yosef S" uniqKey="Haviv Y" first="Yosef S." last="Haviv">Yosef S. Haviv</name><affiliation><nlm:aff id="N0x3dbe7e0N0x37d9ce0">Division of Nephrology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel;</nlm:aff></affiliation></author><author><name sortKey="Yeates, Karen" sort="Yeates, Karen" uniqKey="Yeates K" first="Karen" last="Yeates">Karen Yeates</name><affiliation><nlm:aff id="N0x3dbe7e0N0x37d9ce0">Department of Medicine, Queen's University, Kingston, Ontario, Canada;</nlm:aff></affiliation></author><author><name sortKey="Aguera, Marisa L" sort="Aguera, Marisa L" uniqKey="Aguera M" first="Marisa L." last="Agüera">Marisa L. Agüera</name><affiliation><nlm:aff id="N0x3dbe7e0N0x37d9ce0">Department of Renal Medicine, King's College Hospital, London, United Kingdom;</nlm:aff></affiliation><affiliation><nlm:aff wicri:cut="; and" id="N0x3dbe7e0N0x37d9ce0">Servicio de Nefrologia, Hospital Univeritario Reina Sofia, Córdoba, Spain</nlm:aff></affiliation></author><author><name sortKey="Macrae, Jennifer M" sort="Macrae, Jennifer M" uniqKey="Macrae J" first="Jennifer M." last="Macrae">Jennifer M. Macrae</name><affiliation><nlm:aff id="N0x3dbe7e0N0x37d9ce0">Division of Nephrology, Foothills Medical Centre, Calgary, Alberta, Canada</nlm:aff></affiliation></author><author><name sortKey="Levin, Adeera" sort="Levin, Adeera" uniqKey="Levin A" first="Adeera" last="Levin">Adeera Levin</name><affiliation><nlm:aff id="N0x3dbe7e0N0x37d9ce0">Department of Medicine, Division of Nephrology, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada;</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">19423567</idno><idno type="pmc">2709514</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2709514</idno><idno type="RBID">PMC:2709514</idno><idno type="doi">10.2215/CJN.04920908</idno><date when="2009">2009</date><idno type="wicri:Area/Pmc/Corpus">000F69</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000F69</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Hemoglobin Variability in Nondialysis Chronic Kidney Disease: Examining the Association with Mortality</title><author><name sortKey="Boudville, Neil C" sort="Boudville, Neil C" uniqKey="Boudville N" first="Neil C." last="Boudville">Neil C. Boudville</name><affiliation><nlm:aff id="N0x3dbe7e0N0x37d9ce0">School of Medicine and Pharmacology, University of Western Australia, and Department of Renal Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia;</nlm:aff></affiliation></author><author><name sortKey="Djurdjev, Ognjenka" sort="Djurdjev, Ognjenka" uniqKey="Djurdjev O" first="Ognjenka" last="Djurdjev">Ognjenka Djurdjev</name><affiliation><nlm:aff id="N0x3dbe7e0N0x37d9ce0">Department of Medicine, Division of Nephrology, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada;</nlm:aff></affiliation></author><author><name sortKey="Macdougall, Iain C" sort="Macdougall, Iain C" uniqKey="Macdougall I" first="Iain C." last="Macdougall">Iain C. Macdougall</name><affiliation><nlm:aff id="N0x3dbe7e0N0x37d9ce0">Department of Renal Medicine, King's College Hospital, London, United Kingdom;</nlm:aff></affiliation></author><author><name sortKey="De Francisco, Angel L M" sort="De Francisco, Angel L M" uniqKey="De Francisco A" first="Angel L. M." last="De Francisco">Angel L. M. De Francisco</name><affiliation><nlm:aff id="N0x3dbe7e0N0x37d9ce0">Servicio de Nefrologia, Hospital Universitario Valdecilla, Santander, Spain;</nlm:aff></affiliation></author><author><name sortKey="Deray, Gilbert" sort="Deray, Gilbert" uniqKey="Deray G" first="Gilbert" last="Deray">Gilbert Deray</name><affiliation><nlm:aff id="N0x3dbe7e0N0x37d9ce0">Department of Nephrology, Hospitalier Pitié-Salpetrière, Paris, France;</nlm:aff></affiliation></author><author><name sortKey="Besarab, Anatole" sort="Besarab, Anatole" uniqKey="Besarab A" first="Anatole" last="Besarab">Anatole Besarab</name><affiliation><nlm:aff id="N0x3dbe7e0N0x37d9ce0">Department of Medicine, Division of Nephrology and Hypertension, Henry Ford Health System, Detroit, Michigan;</nlm:aff></affiliation></author><author><name sortKey="Stevens, Paul E" sort="Stevens, Paul E" uniqKey="Stevens P" first="Paul E." last="Stevens">Paul E. Stevens</name><affiliation><nlm:aff id="N0x3dbe7e0N0x37d9ce0">Department of Renal Medicine, Kent and Canterbury Hospital, Canterbury, United Kingdom;</nlm:aff></affiliation></author><author><name sortKey="Walker, Rowan G" sort="Walker, Rowan G" uniqKey="Walker R" first="Rowan G." last="Walker">Rowan G. Walker</name><affiliation><nlm:aff id="N0x3dbe7e0N0x37d9ce0">Department of Nephrology, Royal Melbourne Hospital, Melbourne, Victoria, Australia;</nlm:aff></affiliation></author><author><name sortKey="Ure A, Pablo" sort="Ure A, Pablo" uniqKey="Ure A P" first="Pablo" last="Ure A">Pablo Ure A</name><affiliation><nlm:aff id="N0x3dbe7e0N0x37d9ce0">Service de Néphrologie Dialyse, Clinique du Landy, Saint Ouen, France;</nlm:aff></affiliation></author><author><name sortKey="I Igo, Pablo" sort="I Igo, Pablo" uniqKey="I Igo P" first="Pablo" last="I Igo">Pablo I Igo</name><affiliation><nlm:aff id="N0x3dbe7e0N0x37d9ce0">Servicio de Nefrología, Hospital Clinico Universitario “Lozano Blesa,” Zaragoza, Spain;</nlm:aff></affiliation></author><author><name sortKey="Minutolo, Roberto" sort="Minutolo, Roberto" uniqKey="Minutolo R" first="Roberto" last="Minutolo">Roberto Minutolo</name><affiliation><nlm:aff id="N0x3dbe7e0N0x37d9ce0">Department of Nephrology, Second University of Naples, Naples, Italy;</nlm:aff></affiliation></author><author><name sortKey="Haviv, Yosef S" sort="Haviv, Yosef S" uniqKey="Haviv Y" first="Yosef S." last="Haviv">Yosef S. Haviv</name><affiliation><nlm:aff id="N0x3dbe7e0N0x37d9ce0">Division of Nephrology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel;</nlm:aff></affiliation></author><author><name sortKey="Yeates, Karen" sort="Yeates, Karen" uniqKey="Yeates K" first="Karen" last="Yeates">Karen Yeates</name><affiliation><nlm:aff id="N0x3dbe7e0N0x37d9ce0">Department of Medicine, Queen's University, Kingston, Ontario, Canada;</nlm:aff></affiliation></author><author><name sortKey="Aguera, Marisa L" sort="Aguera, Marisa L" uniqKey="Aguera M" first="Marisa L." last="Agüera">Marisa L. Agüera</name><affiliation><nlm:aff id="N0x3dbe7e0N0x37d9ce0">Department of Renal Medicine, King's College Hospital, London, United Kingdom;</nlm:aff></affiliation><affiliation><nlm:aff wicri:cut="; and" id="N0x3dbe7e0N0x37d9ce0">Servicio de Nefrologia, Hospital Univeritario Reina Sofia, Córdoba, Spain</nlm:aff></affiliation></author><author><name sortKey="Macrae, Jennifer M" sort="Macrae, Jennifer M" uniqKey="Macrae J" first="Jennifer M." last="Macrae">Jennifer M. Macrae</name><affiliation><nlm:aff id="N0x3dbe7e0N0x37d9ce0">Division of Nephrology, Foothills Medical Centre, Calgary, Alberta, Canada</nlm:aff></affiliation></author><author><name sortKey="Levin, Adeera" sort="Levin, Adeera" uniqKey="Levin A" first="Adeera" last="Levin">Adeera Levin</name><affiliation><nlm:aff id="N0x3dbe7e0N0x37d9ce0">Department of Medicine, Division of Nephrology, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada;</nlm:aff></affiliation></author></analytic><series><title level="j">Clinical Journal of the American Society of Nephrology : CJASN</title><idno type="ISSN">1555-9041</idno><idno type="eISSN">1555-905X</idno><imprint><date when="2009">2009</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>Background and objectives: Anemia and hemoglobin (Hb) variability are associated with mortality in hemodialysis patients who are on erythropoiesis-stimulating agents (ESA). Our aim was to describe the degree of Hb variability present in nondialysis patients with chronic kidney disease (CKD), including those who were not receiving ESA, and to investigate the association between Hb variability and mortality.</p><p>Design, setting, participants, & measurements: Hb variability was determined using 6 mo of “baseline” data between January 1, 2003, and October 31, 2005. A variety of definitions for Hb variability were examined to ensure consistency and robustness.</p><p>Results: A total of 6165 patients from 22 centers in seven countries were followed for a mean of 34.0 ± 15.8 mo; 49% were prescribed an ESA. There was increased Hb variability with ESA use; the residual SD of Hb was 4.9 ± 4.4 g/L in patients who were not receiving an ESA, compared with 6.8 ± 4.8 g/L. Hb variability was associated with a small but significantly increased risk for death per g/L residual SD, irrespective of ESA use. Multivariate linear regression model explained only 11% of the total variance of Hb variability.</p><p>Conclusions: Hb variability is increased in patients who have CKD and are receiving ESA and is associated with an increased risk for death (even in those who are not receiving ESAs). This analysis cannot determine whether Hb variability causally affects mortality. Thus, the concept of targeting Hb variability with specific agents needs to be examined within the context of factors that affect both Hb variability and mortality.</p></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Clin J Am Soc Nephrol</journal-id><journal-id journal-id-type="publisher-id">clinjasn</journal-id><journal-title>Clinical Journal of the American Society of Nephrology : CJASN</journal-title><issn pub-type="ppub">1555-9041</issn><issn pub-type="epub">1555-905X</issn><publisher><publisher-name>American Society of Nephrology</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">19423567</article-id><article-id pub-id-type="pmc">2709514</article-id><article-id pub-id-type="publisher-id">0908</article-id><article-id pub-id-type="doi">10.2215/CJN.04920908</article-id><article-categories><subj-group subj-group-type="heading"><subject>Chronic Kidney Disease</subject></subj-group></article-categories><title-group><article-title>Hemoglobin Variability in Nondialysis Chronic Kidney Disease: Examining the Association with Mortality</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Boudville</surname><given-names>Neil C.</given-names></name><xref ref-type="aff" rid="N0x3dbe7e0N0x37d9ce0">*</xref></contrib><contrib contrib-type="author"><name><surname>Djurdjev</surname><given-names>Ognjenka</given-names></name><xref ref-type="aff" rid="N0x3dbe7e0N0x37d9ce0">†</xref></contrib><contrib contrib-type="author"><name><surname>Macdougall</surname><given-names>Iain C.</given-names></name><xref ref-type="aff" rid="N0x3dbe7e0N0x37d9ce0">‡</xref></contrib><contrib contrib-type="author"><name><surname>de Francisco</surname><given-names>Angel L.M.</given-names></name><xref ref-type="aff" rid="N0x3dbe7e0N0x37d9ce0">§</xref></contrib><contrib contrib-type="author"><name><surname>Deray</surname><given-names>Gilbert</given-names></name><xref ref-type="aff" rid="N0x3dbe7e0N0x37d9ce0">‖</xref></contrib><contrib contrib-type="author"><name><surname>Besarab</surname><given-names>Anatole</given-names></name><xref ref-type="aff" rid="N0x3dbe7e0N0x37d9ce0">¶</xref></contrib><contrib contrib-type="author"><name><surname>Stevens</surname><given-names>Paul E.</given-names></name><xref ref-type="aff" rid="N0x3dbe7e0N0x37d9ce0">**</xref></contrib><contrib contrib-type="author"><name><surname>Walker</surname><given-names>Rowan G.</given-names></name><xref ref-type="aff" rid="N0x3dbe7e0N0x37d9ce0">††</xref></contrib><contrib contrib-type="author"><name><surname>Ureña</surname><given-names>Pablo</given-names></name><xref ref-type="aff" rid="N0x3dbe7e0N0x37d9ce0">‡‡</xref></contrib><contrib contrib-type="author"><name><surname>Iñigo</surname><given-names>Pablo</given-names></name><xref ref-type="aff" rid="N0x3dbe7e0N0x37d9ce0">§§</xref></contrib><contrib contrib-type="author"><name><surname>Minutolo</surname><given-names>Roberto</given-names></name><xref ref-type="aff" rid="N0x3dbe7e0N0x37d9ce0">‖‖</xref></contrib><contrib contrib-type="author"><name><surname>Haviv</surname><given-names>Yosef S.</given-names></name><xref ref-type="aff" rid="N0x3dbe7e0N0x37d9ce0">¶¶</xref></contrib><contrib contrib-type="author"><name><surname>Yeates</surname><given-names>Karen</given-names></name><xref ref-type="aff" rid="N0x3dbe7e0N0x37d9ce0">***</xref></contrib><contrib contrib-type="author"><name><surname>Agüera</surname><given-names>Marisa L.</given-names></name><xref ref-type="aff" rid="N0x3dbe7e0N0x37d9ce0">‡</xref><xref ref-type="aff" rid="N0x3dbe7e0N0x37d9ce0">†††</xref></contrib><contrib contrib-type="author"><name><surname>MacRae</surname><given-names>Jennifer M.</given-names></name><xref ref-type="aff" rid="N0x3dbe7e0N0x37d9ce0">‡‡‡</xref></contrib><contrib contrib-type="author"><name><surname>Levin</surname><given-names>Adeera</given-names></name><xref ref-type="aff" rid="N0x3dbe7e0N0x37d9ce0">†</xref></contrib></contrib-group><aff id="N0x3dbe7e0N0x37d9ce0"><label>*</label>School of Medicine and Pharmacology, University of Western Australia, and Department of Renal Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia;<label>†</label>Department of Medicine, Division of Nephrology, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada;<label>‡</label>Department of Renal Medicine, King's College Hospital, London, United Kingdom;<label>§</label>Servicio de Nefrologia, Hospital Universitario Valdecilla, Santander, Spain;<label>‖</label>Department of Nephrology, Hospitalier Pitié-Salpetrière, Paris, France;<label>¶</label>Department of Medicine, Division of Nephrology and Hypertension, Henry Ford Health System, Detroit, Michigan;<label>**</label>Department of Renal Medicine, Kent and Canterbury Hospital, Canterbury, United Kingdom;<label>††</label>Department of Nephrology, Royal Melbourne Hospital, Melbourne, Victoria, Australia;<label>‡‡</label>Service de Néphrologie Dialyse, Clinique du Landy, Saint Ouen, France;<label>§§</label>Servicio de Nefrología, Hospital Clinico Universitario “Lozano Blesa,” Zaragoza, Spain;<label>‖‖</label>Department of Nephrology, Second University of Naples, Naples, Italy;<label>¶¶</label>Division of Nephrology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel;<label>***</label>Department of Medicine, Queen's University, Kingston, Ontario, Canada;<label>†††</label>Servicio de Nefrologia, Hospital Univeritario Reina Sofia, Córdoba, Spain; and<label>‡‡‡</label>Division of Nephrology, Foothills Medical Centre, Calgary, Alberta, Canada</aff><author-notes><fn><p><bold>Correspondence:</bold> Dr. Neil Boudville, School of Medicine and Pharmacology, M503, 4th Floor G Block, Sir Charles Gairdner Hospital, Verdun Street, Nedlands, WA, Australia 6009. Phone: 61-8-9346-3333; Fax: 61-8-9346-2816; E-mail: <email>neil.boudville@uwa.edu.au</email></p></fn></author-notes><pub-date pub-type="ppub"><month>7</month><year>2009</year></pub-date><pub-date pub-type="pmc-release"><day>1</day><month>7</month><year>2010</year></pub-date><pmc-comment> PMC Release delay is 12 months and 0 days and was based on the copyright element. </pmc-comment>
<volume>4</volume><issue>7</issue><fpage>1176</fpage><lpage>1182</lpage><history><date date-type="received"><day>25</day><month>9</month><year>2008</year></date><date date-type="accepted"><day>13</day><month>4</month><year>2009</year></date></history><permissions><copyright-statement>Copyright © 2009 by the American Society of Nephrology</copyright-statement></permissions><self-uri xlink:title="pdf" xlink:href="cjn00709001176.pdf"></self-uri><abstract><p>Background and objectives: Anemia and hemoglobin (Hb) variability are associated with mortality in hemodialysis patients who are on erythropoiesis-stimulating agents (ESA). Our aim was to describe the degree of Hb variability present in nondialysis patients with chronic kidney disease (CKD), including those who were not receiving ESA, and to investigate the association between Hb variability and mortality.</p><p>Design, setting, participants, & measurements: Hb variability was determined using 6 mo of “baseline” data between January 1, 2003, and October 31, 2005. A variety of definitions for Hb variability were examined to ensure consistency and robustness.</p><p>Results: A total of 6165 patients from 22 centers in seven countries were followed for a mean of 34.0 ± 15.8 mo; 49% were prescribed an ESA. There was increased Hb variability with ESA use; the residual SD of Hb was 4.9 ± 4.4 g/L in patients who were not receiving an ESA, compared with 6.8 ± 4.8 g/L. Hb variability was associated with a small but significantly increased risk for death per g/L residual SD, irrespective of ESA use. Multivariate linear regression model explained only 11% of the total variance of Hb variability.</p><p>Conclusions: Hb variability is increased in patients who have CKD and are receiving ESA and is associated with an increased risk for death (even in those who are not receiving ESAs). This analysis cannot determine whether Hb variability causally affects mortality. Thus, the concept of targeting Hb variability with specific agents needs to be examined within the context of factors that affect both Hb variability and mortality.</p></abstract></article-meta><notes><fn-group><fn><p>Published online ahead of print. Publication date available at <ext-link ext-link-type="uri" xlink:href="www.cjasn.org">www.cjasn.org</ext-link>.</p></fn></fn-group></notes></front><floats-wrap><fig position="float" id="f1"><label>Figure 1.</label><caption><p>Flowchart of cohort derivation.</p></caption><graphic xlink:href="cjn0070928860001"></graphic></fig><fig position="float" id="f2"><label>Figure 2.</label><caption><p>Survival curves for Hb categories. Groups with anemia—especially persistent—had the greatest risk for death, even more than the group with the greatest degree of variability (<italic>P</italic> < 0.0001).</p></caption><graphic xlink:href="cjn0070928860002"></graphic></fig><table-wrap position="float" id="t1"><label>Table 1.</label><caption><p>Demographics based on ESA use during the baseline period<xref ref-type="table-fn" rid="t1fn1">a</xref></p></caption><table frame="hsides" rules="groups"><thead><tr><th colspan="1" rowspan="1" align="center" valign="bottom">Variable</th><th colspan="1" rowspan="1" align="center" valign="bottom">No ESA Use (<italic>n</italic> = 3143)</th><th colspan="1" rowspan="1" align="center" valign="bottom">On ESA Throughout (<italic>n</italic> = 1823)</th><th colspan="1" rowspan="1" align="center" valign="bottom">Commenced ESA (<italic>n</italic> = 1199)</th><th colspan="1" rowspan="1" align="center" valign="bottom">Total (<italic>n</italic> = 6165)</th><th colspan="1" rowspan="1" align="center" valign="bottom"><italic>P</italic></th></tr></thead><tbody><tr><td colspan="1" rowspan="1" align="left" valign="top">Age (yr; mean ± SD)</td><td colspan="1" rowspan="1" align="center" valign="top">68.5 ± 13.2</td><td colspan="1" rowspan="1" align="center" valign="top">70.0 ± 14.3</td><td colspan="1" rowspan="1" align="center" valign="top">68.9 ± 13.7</td><td colspan="1" rowspan="1" align="center" valign="top">69.0 ± 13.7</td><td colspan="1" rowspan="1" align="char" char="." valign="top">0.0008</td></tr><tr><td colspan="1" rowspan="1" align="left" valign="top">Male (%)</td><td colspan="1" rowspan="1" align="center" valign="top">61.6</td><td colspan="1" rowspan="1" align="center" valign="top">51.1</td><td colspan="1" rowspan="1" align="center" valign="top">53.5</td><td colspan="1" rowspan="1" align="center" valign="top">56.9</td><td colspan="1" rowspan="1" align="char" char="." valign="top"><0.0001</td></tr><tr><td colspan="1" rowspan="1" align="left" valign="top">Race (%)</td><td colspan="1" rowspan="1" align="center" valign="top"></td><td colspan="1" rowspan="1" align="center" valign="top"></td><td colspan="1" rowspan="1" align="center" valign="top"></td><td colspan="1" rowspan="1" align="center" valign="top"></td><td colspan="1" rowspan="1" align="char" char="." valign="top"><0.0001</td></tr><tr><td colspan="1" rowspan="1" align="left" valign="top"> white</td><td colspan="1" rowspan="1" align="center" valign="top">78.8</td><td colspan="1" rowspan="1" align="center" valign="top">66.7</td><td colspan="1" rowspan="1" align="center" valign="top">69.7</td><td colspan="1" rowspan="1" align="center" valign="top">73.3</td><td colspan="1" rowspan="1" align="center" valign="top"></td></tr><tr><td colspan="1" rowspan="1" align="left" valign="top"> Asian</td><td colspan="1" rowspan="1" align="center" valign="top">15.8</td><td colspan="1" rowspan="1" align="center" valign="top">28.0</td><td colspan="1" rowspan="1" align="center" valign="top">23.5</td><td colspan="1" rowspan="1" align="center" valign="top">21.1</td><td colspan="1" rowspan="1" align="center" valign="top"></td></tr><tr><td colspan="1" rowspan="1" align="left" valign="top"> other</td><td colspan="1" rowspan="1" align="center" valign="top">5.4</td><td colspan="1" rowspan="1" align="center" valign="top">5.3</td><td colspan="1" rowspan="1" align="center" valign="top">6.8</td><td colspan="1" rowspan="1" align="center" valign="top">5.6</td><td colspan="1" rowspan="1" align="center" valign="top"></td></tr><tr><td colspan="1" rowspan="1" align="left" valign="top">GFR (ml/min per 1.73 m<sup>2</sup>; mean ± SD)</td><td colspan="1" rowspan="1" align="center" valign="top">27.7 ± 11.3</td><td colspan="1" rowspan="1" align="center" valign="top">23.8 ± 10.8</td><td colspan="1" rowspan="1" align="center" valign="top">21.9 ± 10.1</td><td colspan="1" rowspan="1" align="center" valign="top">25.4 ± 11.2</td><td colspan="1" rowspan="1" align="char" char="." valign="top"><0.0001</td></tr><tr><td colspan="1" rowspan="1" align="left" valign="top"> 30 to 60 (%)</td><td colspan="1" rowspan="1" align="center" valign="top">40.2</td><td colspan="1" rowspan="1" align="center" valign="top">27.5</td><td colspan="1" rowspan="1" align="center" valign="top">20.6</td><td colspan="1" rowspan="1" align="center" valign="top">32.6</td><td colspan="1" rowspan="1" align="center" valign="top"></td></tr><tr><td colspan="1" rowspan="1" align="left" valign="top"> 15 to 30 (%)</td><td colspan="1" rowspan="1" align="center" valign="top">47.4</td><td colspan="1" rowspan="1" align="center" valign="top">49.8</td><td colspan="1" rowspan="1" align="center" valign="top">52.5</td><td colspan="1" rowspan="1" align="center" valign="top">49.1</td><td colspan="1" rowspan="1" align="center" valign="top"></td></tr><tr><td colspan="1" rowspan="1" align="left" valign="top"> <15 (%)</td><td colspan="1" rowspan="1" align="center" valign="top">12.4</td><td colspan="1" rowspan="1" align="center" valign="top">22.8</td><td colspan="1" rowspan="1" align="center" valign="top">27.0</td><td colspan="1" rowspan="1" align="center" valign="top">18.3</td><td colspan="1" rowspan="1" align="center" valign="top"></td></tr><tr><td colspan="1" rowspan="1" align="left" valign="top">Hemoglobin (g/L; mean ± SD)</td><td colspan="1" rowspan="1" align="center" valign="top">125.0 ± 15.7</td><td colspan="1" rowspan="1" align="center" valign="top">110.9 ± 15.5</td><td colspan="1" rowspan="1" align="center" valign="top">103.0 ± 12.6</td><td colspan="1" rowspan="1" align="center" valign="top">116.5 ± 17.6</td><td colspan="1" rowspan="1" align="char" char="." valign="top"><0.0001</td></tr><tr><td colspan="1" rowspan="1" align="left" valign="top">Diabetes (%)</td><td colspan="1" rowspan="1" align="center" valign="top">36.5</td><td colspan="1" rowspan="1" align="center" valign="top">34.1</td><td colspan="1" rowspan="1" align="center" valign="top">38.7</td><td colspan="1" rowspan="1" align="center" valign="top">36.2</td><td colspan="1" rowspan="1" align="char" char="." valign="top">0.038</td></tr><tr><td colspan="1" rowspan="1" align="left" valign="top">Follow-up (mo; mean ± SD)</td><td colspan="1" rowspan="1" align="center" valign="top">34.6 ± 15.0</td><td colspan="1" rowspan="1" align="center" valign="top">34.6 ± 17.4</td><td colspan="1" rowspan="1" align="center" valign="top">31.3 ± 15.0</td><td colspan="1" rowspan="1" align="center" valign="top">34.0 ± 15.8</td><td colspan="1" rowspan="1" align="char" char="." valign="top"><0.0001</td></tr><tr><td colspan="1" rowspan="1" align="left" valign="top">Hb measurements during baseline period</td><td colspan="1" rowspan="1" align="center" valign="top"></td><td colspan="1" rowspan="1" align="center" valign="top"></td><td colspan="1" rowspan="1" align="center" valign="top"></td><td colspan="1" rowspan="1" align="center" valign="top"></td><td colspan="1" rowspan="1" align="center" valign="top"></td></tr><tr><td colspan="1" rowspan="1" align="left" valign="top"> n (range)</td><td colspan="1" rowspan="1" align="center" valign="top">4 (3 to 7)</td><td colspan="1" rowspan="1" align="center" valign="top">4 (3 to 7)</td><td colspan="1" rowspan="1" align="center" valign="top">5 (3 to 7)</td><td colspan="1" rowspan="1" align="center" valign="top">5 (3 to 7)</td><td colspan="1" rowspan="1" align="center" valign="top"></td></tr><tr><td colspan="1" rowspan="1" align="left" valign="top"> mean ± SD</td><td colspan="1" rowspan="1" align="center" valign="top">4.52 ± 1.37</td><td colspan="1" rowspan="1" align="center" valign="top">4.09 ± 1.23</td><td colspan="1" rowspan="1" align="center" valign="top">4.83 ± 1.34</td><td colspan="1" rowspan="1" align="center" valign="top">5.05 ± 1.38</td><td colspan="1" rowspan="1" align="char" char="." valign="top"><0.0001</td></tr></tbody></table><table-wrap-foot><fn id="t1fn1"><label>a</label><p>ESA, erythropoiesis-stimulating agent; Hb, hemoglobin.</p></fn></table-wrap-foot></table-wrap><table-wrap position="float" id="t2"><label>Table 2.</label><caption><p>Intraindividual variability in Hb levels dependent on ESA usage, defined by residual SD of Hb, intraindividual change in Hb in consecutive measurements, Hb amplitude, and Hb category</p></caption><table frame="hsides" rules="groups"><thead><tr><th colspan="1" rowspan="1" align="center" valign="bottom">Hb Variability Definitions</th><th colspan="1" rowspan="1" align="center" valign="bottom">No ESA Use (<italic>n</italic> = 3143)</th><th colspan="1" rowspan="1" align="center" valign="bottom">On ESA Throughout (<italic>n</italic> = 1823)</th><th colspan="1" rowspan="1" align="center" valign="bottom">Commenced ESA (<italic>n</italic> = 1199)</th><th colspan="1" rowspan="1" align="center" valign="bottom"><italic>P</italic></th></tr></thead><tbody><tr><td colspan="1" rowspan="1" align="left" valign="top">Hb intercept (g/L; mean ± SD)</td><td colspan="1" rowspan="1" align="center" valign="top">124.9 ± 15.3</td><td colspan="1" rowspan="1" align="center" valign="top">112.6 ± 15.4</td><td colspan="1" rowspan="1" align="center" valign="top">103.1 ± 11.8</td><td colspan="1" rowspan="1" align="char" char="." valign="top"><0.0001</td></tr><tr><td colspan="1" rowspan="1" align="left" valign="top">Hb slope (g/L per mo; mean ± SD)</td><td colspan="1" rowspan="1" align="center" valign="top">−0.1 ± 2.6</td><td colspan="1" rowspan="1" align="center" valign="top">1.4 ± 4.1</td><td colspan="1" rowspan="1" align="center" valign="top">2.7 ± 4.0</td><td colspan="1" rowspan="1" align="char" char="." valign="top"><0.0001</td></tr><tr><td colspan="1" rowspan="1" align="left" valign="top">Residual SD (g/L; mean ± SD)</td><td colspan="1" rowspan="1" align="center" valign="top">4.9 ± 4.4</td><td colspan="1" rowspan="1" align="center" valign="top">6.8 ± 4.8</td><td colspan="1" rowspan="1" align="center" valign="top">7.3 ± 4.9</td><td colspan="1" rowspan="1" align="char" char="." valign="top"><0.0001</td></tr><tr><td colspan="1" rowspan="1" align="left" valign="top">Intraindividual change in Hb (g/L; mean ± SD)</td><td colspan="1" rowspan="1" align="center" valign="top">6.6 ± 5.3</td><td colspan="1" rowspan="1" align="center" valign="top">8.6 ± 5.5</td><td colspan="1" rowspan="1" align="center" valign="top">9.7 ± 5.6</td><td colspan="1" rowspan="1" align="char" char="." valign="top"><0.0001</td></tr><tr><td colspan="1" rowspan="1" align="left" valign="top">SD of intraindividual change in Hb (g/L; mean ± SD)</td><td colspan="1" rowspan="1" align="center" valign="top">8.0 ± 7.4</td><td colspan="1" rowspan="1" align="center" valign="top">10.0 ± 7.2</td><td colspan="1" rowspan="1" align="center" valign="top">11.1 ± 7.5</td><td colspan="1" rowspan="1" align="char" char="." valign="top"><0.0001</td></tr><tr><td colspan="1" rowspan="1" align="left" valign="top">Hb change (%)</td><td colspan="1" rowspan="1" align="center" valign="top"></td><td colspan="1" rowspan="1" align="center" valign="top"></td><td colspan="1" rowspan="1" align="center" valign="top"></td><td colspan="1" rowspan="1" align="center" valign="top"></td></tr><tr><td colspan="1" rowspan="1" align="left" valign="top"> all consecutive Hb change ≤5 g/L</td><td colspan="1" rowspan="1" align="char" char="." valign="top">25.1</td><td colspan="1" rowspan="1" align="char" char="." valign="top">7.4</td><td colspan="1" rowspan="1" align="char" char="." valign="top">4.7</td><td colspan="1" rowspan="1" align="char" char="." valign="top"><0.0001</td></tr><tr><td colspan="1" rowspan="1" align="left" valign="top"> consecutive Hb decrease >5 g/L</td><td colspan="1" rowspan="1" align="char" char="." valign="top">19.9</td><td colspan="1" rowspan="1" align="char" char="." valign="top">31.0</td><td colspan="1" rowspan="1" align="char" char="." valign="top">38.8</td><td colspan="1" rowspan="1" align="center" valign="top"></td></tr><tr><td colspan="1" rowspan="1" align="left" valign="top"> consecutive Hb increase >5 g/L</td><td colspan="1" rowspan="1" align="char" char="." valign="top">24.1</td><td colspan="1" rowspan="1" align="char" char="." valign="top">11.8</td><td colspan="1" rowspan="1" align="char" char="." valign="top">7.3</td><td colspan="1" rowspan="1" align="center" valign="top"></td></tr><tr><td colspan="1" rowspan="1" align="left" valign="top"> both consecutive Hb decrease and increase >5 g/L</td><td colspan="1" rowspan="1" align="char" char="." valign="top">30.9</td><td colspan="1" rowspan="1" align="char" char="." valign="top">49.8</td><td colspan="1" rowspan="1" align="char" char="." valign="top">49.2</td><td colspan="1" rowspan="1" align="center" valign="top"></td></tr><tr><td colspan="1" rowspan="1" align="left" valign="top">Hb amplitude (g/L; %)</td><td colspan="1" rowspan="1" align="center" valign="top"></td><td colspan="1" rowspan="1" align="center" valign="top"></td><td colspan="1" rowspan="1" align="center" valign="top"></td><td colspan="1" rowspan="1" align="center" valign="top"></td></tr><tr><td colspan="1" rowspan="1" align="left" valign="top"> 0 to 10</td><td colspan="1" rowspan="1" align="char" char="." valign="top">50.0</td><td colspan="1" rowspan="1" align="char" char="." valign="top">18.2</td><td colspan="1" rowspan="1" align="char" char="." valign="top">12.9</td><td colspan="1" rowspan="1" align="char" char="." valign="top"><0.0001</td></tr><tr><td colspan="1" rowspan="1" align="left" valign="top"> 11 to 20</td><td colspan="1" rowspan="1" align="char" char="." valign="top">33.7</td><td colspan="1" rowspan="1" align="char" char="." valign="top">37.0</td><td colspan="1" rowspan="1" align="char" char="." valign="top">33.3</td><td colspan="1" rowspan="1" align="center" valign="top"></td></tr><tr><td colspan="1" rowspan="1" align="left" valign="top"> >20</td><td colspan="1" rowspan="1" align="char" char="." valign="top">16.3</td><td colspan="1" rowspan="1" align="char" char="." valign="top">44.8</td><td colspan="1" rowspan="1" align="char" char="." valign="top">53.8</td><td colspan="1" rowspan="1" align="center" valign="top"></td></tr><tr><td colspan="1" rowspan="1" align="left" valign="top">Classification of Hb variability (%)</td><td colspan="1" rowspan="1" align="center" valign="top"></td><td colspan="1" rowspan="1" align="center" valign="top"></td><td colspan="1" rowspan="1" align="center" valign="top"></td><td colspan="1" rowspan="1" align="char" char="." valign="top"><0.0001</td></tr><tr><td colspan="1" rowspan="1" align="left" valign="top"> group I (Hb >130 g/L)</td><td colspan="1" rowspan="1" align="char" char="." valign="top">22.8</td><td colspan="1" rowspan="1" align="char" char="." valign="top">2.9</td><td colspan="1" rowspan="1" align="char" char="." valign="top">0.3</td><td colspan="1" rowspan="1" align="center" valign="top"></td></tr><tr><td colspan="1" rowspan="1" align="left" valign="top"> group II (Hb >130 and 110 to 130 g/L)</td><td colspan="1" rowspan="1" align="char" char="." valign="top">24.1</td><td colspan="1" rowspan="1" align="char" char="." valign="top">22.3</td><td colspan="1" rowspan="1" align="char" char="." valign="top">4.6</td><td colspan="1" rowspan="1" align="center" valign="top"></td></tr><tr><td colspan="1" rowspan="1" align="left" valign="top"> group III (Hb 110 to 130 g/L)</td><td colspan="1" rowspan="1" align="char" char="." valign="top">24.6</td><td colspan="1" rowspan="1" align="char" char="." valign="top">12.8</td><td colspan="1" rowspan="1" align="char" char="." valign="top">5.1</td><td colspan="1" rowspan="1" align="center" valign="top"></td></tr><tr><td colspan="1" rowspan="1" align="left" valign="top"> group IV (Hb 110 to 130 and <110 g/L)</td><td colspan="1" rowspan="1" align="char" char="." valign="top">18.4</td><td colspan="1" rowspan="1" align="char" char="." valign="top">33.9</td><td colspan="1" rowspan="1" align="char" char="." valign="top">49.6</td><td colspan="1" rowspan="1" align="center" valign="top"></td></tr><tr><td colspan="1" rowspan="1" align="left" valign="top"> group V (Hb <110 g/L)</td><td colspan="1" rowspan="1" align="char" char="." valign="top">5.4</td><td colspan="1" rowspan="1" align="char" char="." valign="top">11.1</td><td colspan="1" rowspan="1" align="char" char="." valign="top">17.3</td><td colspan="1" rowspan="1" align="center" valign="top"></td></tr><tr><td colspan="1" rowspan="1" align="left" valign="top"> group VI (Hb >130 and 110 to 130 and <110 g/L)</td><td colspan="1" rowspan="1" align="char" char="." valign="top">4.7</td><td colspan="1" rowspan="1" align="char" char="." valign="top">17.0</td><td colspan="1" rowspan="1" align="char" char="." valign="top">23.1</td><td colspan="1" rowspan="1" align="center" valign="top"></td></tr></tbody></table></table-wrap><table-wrap position="float" id="t3"><label>Table 3.</label><caption><p>Multivariate model of factors associated with mortality, with groups based on ESA use during the baseline period<xref ref-type="table-fn" rid="t3fn1">a</xref></p></caption><table frame="hsides" rules="groups"><thead><tr><th colspan="1" rowspan="2" align="center" valign="bottom">Variable</th><th colspan="3" rowspan="1" align="center" valign="bottom">No ESA Use (<italic>n</italic> = 3143)
<hr></hr></th><th colspan="3" rowspan="1" align="center" valign="bottom">On ESA Throughout (<italic>n</italic> = 1823)
<hr></hr></th></tr><tr><th colspan="1" rowspan="1" align="center" valign="bottom">HR</th><th colspan="1" rowspan="1" align="center" valign="bottom">95% CI</th><th colspan="1" rowspan="1" align="center" valign="bottom"><italic>P</italic></th><th colspan="1" rowspan="1" align="center" valign="bottom">HR</th><th colspan="1" rowspan="1" align="center" valign="bottom">95% CI</th><th colspan="1" rowspan="1" align="center" valign="bottom"><italic>P</italic></th></tr></thead><tbody><tr><td colspan="1" rowspan="1" align="left" valign="top">Age (per 10 yr)</td><td colspan="1" rowspan="1" align="char" char="." valign="top">1.57</td><td colspan="1" rowspan="1" align="center" valign="top">1.46 to 1.70</td><td colspan="1" rowspan="1" align="char" char="." valign="top"><0.001</td><td colspan="1" rowspan="1" align="char" char="." valign="top">1.53</td><td colspan="1" rowspan="1" align="center" valign="top">1.41 to 1.65</td><td colspan="1" rowspan="1" align="char" char="." valign="top"><0.001</td></tr><tr><td colspan="1" rowspan="1" align="left" valign="top">Male</td><td colspan="1" rowspan="1" align="char" char="." valign="top">1.25</td><td colspan="1" rowspan="1" align="center" valign="top">1.06 to 1.48</td><td colspan="1" rowspan="1" align="char" char="." valign="top">0.01</td><td colspan="1" rowspan="1" align="char" char="." valign="top">1.14</td><td colspan="1" rowspan="1" align="center" valign="top">0.96 to 1.35</td><td colspan="1" rowspan="1" align="char" char="." valign="top">0.13</td></tr><tr><td colspan="1" rowspan="1" align="left" valign="top">Diabetes</td><td colspan="1" rowspan="1" align="char" char="." valign="top">1.31</td><td colspan="1" rowspan="1" align="center" valign="top">1.12 to 1.54</td><td colspan="1" rowspan="1" align="char" char="." valign="top">0.001</td><td colspan="1" rowspan="1" align="char" char="." valign="top">0.94</td><td colspan="1" rowspan="1" align="center" valign="top">0.79 to 1.12</td><td colspan="1" rowspan="1" align="char" char="." valign="top">0.49</td></tr><tr><td colspan="1" rowspan="1" align="left" valign="top">GFR (per 5 ml/min)</td><td colspan="1" rowspan="1" align="char" char="." valign="top">0.84</td><td colspan="1" rowspan="1" align="center" valign="top">0.80 to 0.88</td><td colspan="1" rowspan="1" align="char" char="." valign="top"><0.001</td><td colspan="1" rowspan="1" align="char" char="." valign="top">0.93</td><td colspan="1" rowspan="1" align="center" valign="top">0.88 to 0.97</td><td colspan="1" rowspan="1" align="char" char="." valign="top">0.001</td></tr><tr><td colspan="1" rowspan="1" align="left" valign="top">Dialysis initiation</td><td colspan="1" rowspan="1" align="char" char="." valign="top">1.94</td><td colspan="1" rowspan="1" align="center" valign="top">1.58 to 2.38</td><td colspan="1" rowspan="1" align="char" char="." valign="top"><0.001</td><td colspan="1" rowspan="1" align="char" char="." valign="top">1.70</td><td colspan="1" rowspan="1" align="center" valign="top">1.37 to 2.11</td><td colspan="1" rowspan="1" align="char" char="." valign="top"><0.001</td></tr><tr><td colspan="1" rowspan="1" align="left" valign="top">Absolute Hb (intercept; g/L)</td><td colspan="1" rowspan="1" align="char" char="." valign="top">0.99</td><td colspan="1" rowspan="1" align="center" valign="top">0.980 to 0.993</td><td colspan="1" rowspan="1" align="char" char="." valign="top"><0.001</td><td colspan="1" rowspan="1" align="char" char="." valign="top">0.99</td><td colspan="1" rowspan="1" align="center" valign="top">0.980 to 0.993</td><td colspan="1" rowspan="1" align="char" char="." valign="top"><0.001</td></tr><tr><td colspan="1" rowspan="1" align="left" valign="top">Hb trend (slope; g/L per mo)</td><td colspan="1" rowspan="1" align="char" char="." valign="top">0.96</td><td colspan="1" rowspan="1" align="center" valign="top">0.93 to 0.99</td><td colspan="1" rowspan="1" align="char" char="." valign="top">0.013</td><td colspan="1" rowspan="1" align="char" char="." valign="top">0.94</td><td colspan="1" rowspan="1" align="center" valign="top">0.92 to 0.97</td><td colspan="1" rowspan="1" align="char" char="." valign="top"><0.001</td></tr><tr><td colspan="1" rowspan="1" align="left" valign="top">Residual SD (g/L)</td><td colspan="1" rowspan="1" align="char" char="." valign="top">1.03</td><td colspan="1" rowspan="1" align="center" valign="top">1.02 to 1.05</td><td colspan="1" rowspan="1" align="char" char="." valign="top"><0.001</td><td colspan="1" rowspan="1" align="char" char="." valign="top">1.02</td><td colspan="1" rowspan="1" align="center" valign="top">1.01 to 1.04</td><td colspan="1" rowspan="1" align="char" char="." valign="top">0.008</td></tr></tbody></table><table-wrap-foot><fn id="t3fn1"><label>a</label><p>CI, confidence interval; HR, hazard ratio.</p></fn></table-wrap-foot></table-wrap><table-wrap position="float" id="t4"><label>Table 4.</label><caption><p>Hb parameters (anemia and variability) associated with mortality in multivariate analysis on all patients except for those who commenced ESA therapy during the baseline period (<italic>n</italic> = 4966)<xref ref-type="table-fn" rid="t4fn1">a</xref></p></caption><table frame="hsides" rules="groups"><thead><tr><th colspan="1" rowspan="1" align="center" valign="bottom">Variable</th><th colspan="1" rowspan="1" align="center" valign="bottom">HR</th><th colspan="1" rowspan="1" align="center" valign="bottom">95% CI</th><th colspan="1" rowspan="1" align="center" valign="bottom"><italic>P</italic></th></tr></thead><tbody><tr><td colspan="1" rowspan="1" align="left" valign="top">Model with regression-based Hb parameters</td><td colspan="1" rowspan="1" align="center" valign="top"></td><td colspan="1" rowspan="1" align="center" valign="top"></td><td colspan="1" rowspan="1" align="center" valign="top"></td></tr><tr><td colspan="1" rowspan="1" align="left" valign="top"> age (per 10 yr)</td><td colspan="1" rowspan="1" align="char" char="." valign="top">1.55</td><td colspan="1" rowspan="1" align="center" valign="top">1.47 to 1.64</td><td colspan="1" rowspan="1" align="char" char="." valign="top"><0.001</td></tr><tr><td colspan="1" rowspan="1" align="left" valign="top"> male</td><td colspan="1" rowspan="1" align="char" char="." valign="top">1.21</td><td colspan="1" rowspan="1" align="center" valign="top">1.07 to 1.36</td><td colspan="1" rowspan="1" align="char" char="." valign="top">0.002</td></tr><tr><td colspan="1" rowspan="1" align="left" valign="top"> GFR (per 5 ml/min)</td><td colspan="1" rowspan="1" align="char" char="." valign="top">0.88</td><td colspan="1" rowspan="1" align="center" valign="top">0.85 to 0.91</td><td colspan="1" rowspan="1" align="char" char="." valign="top"><0.001</td></tr><tr><td colspan="1" rowspan="1" align="left" valign="top"> dialysis initiation</td><td colspan="1" rowspan="1" align="char" char="." valign="top">1.76</td><td colspan="1" rowspan="1" align="center" valign="top">1.52 to 2.05</td><td colspan="1" rowspan="1" align="char" char="." valign="top"><0.001</td></tr><tr><td colspan="1" rowspan="1" align="left" valign="top"> absolute Hb (intercept; g/L)</td><td colspan="1" rowspan="1" align="char" char="." valign="top">0.99</td><td colspan="1" rowspan="1" align="center" valign="top">0.98 to 0.99</td><td colspan="1" rowspan="1" align="char" char="." valign="top"><0.001</td></tr><tr><td colspan="1" rowspan="1" align="left" valign="top"> Hb trend (slope; g/L per mo)</td><td colspan="1" rowspan="1" align="char" char="." valign="top">0.95</td><td colspan="1" rowspan="1" align="center" valign="top">0.93 to 0.97</td><td colspan="1" rowspan="1" align="char" char="." valign="top"><0.001</td></tr><tr><td colspan="1" rowspan="1" align="left" valign="top"> residual SD (g/L)</td><td colspan="1" rowspan="1" align="char" char="." valign="top">1.03</td><td colspan="1" rowspan="1" align="center" valign="top">1.02 to 1.04</td><td colspan="1" rowspan="1" align="char" char="." valign="top"><0.001</td></tr><tr><td colspan="1" rowspan="1" align="left" valign="top">Model with regression-based Hb parameters and six-group classification of Hb parameters</td><td colspan="1" rowspan="1" align="center" valign="top"></td><td colspan="1" rowspan="1" align="center" valign="top"></td><td colspan="1" rowspan="1" align="center" valign="top"></td></tr><tr><td colspan="1" rowspan="1" align="left" valign="top"> age (per 10 yr)</td><td colspan="1" rowspan="1" align="char" char="." valign="top">1.55</td><td colspan="1" rowspan="1" align="center" valign="top">1.47 to 1.64</td><td colspan="1" rowspan="1" align="char" char="." valign="top"><0.001</td></tr><tr><td colspan="1" rowspan="1" align="left" valign="top"> male</td><td colspan="1" rowspan="1" align="char" char="." valign="top">1.20</td><td colspan="1" rowspan="1" align="center" valign="top">1.07 to 1.36</td><td colspan="1" rowspan="1" align="char" char="." valign="top">0.002</td></tr><tr><td colspan="1" rowspan="1" align="left" valign="top"> GFR (per 5 ml/min)</td><td colspan="1" rowspan="1" align="char" char="." valign="top">0.87</td><td colspan="1" rowspan="1" align="center" valign="top">0.84 to 0.90</td><td colspan="1" rowspan="1" align="char" char="." valign="top"><0.001</td></tr><tr><td colspan="1" rowspan="1" align="left" valign="top"> dialysis initiation</td><td colspan="1" rowspan="1" align="char" char="." valign="top">1.80</td><td colspan="1" rowspan="1" align="center" valign="top">1.54 to 2.08</td><td colspan="1" rowspan="1" align="char" char="." valign="top"><0.001</td></tr><tr><td colspan="1" rowspan="1" align="left" valign="top"> group III (Hb 110 to 130 g/L; reference)</td><td colspan="1" rowspan="1" align="char" char="." valign="top">1.00</td><td colspan="1" rowspan="1" align="center" valign="top"></td><td colspan="1" rowspan="1" align="center" valign="top"></td></tr><tr><td colspan="1" rowspan="1" align="left" valign="top"> group I (Hb >130 g/L)</td><td colspan="1" rowspan="1" align="char" char="." valign="top">1.001</td><td colspan="1" rowspan="1" align="center" valign="top">0.79 to 1.27</td><td colspan="1" rowspan="1" align="char" char="." valign="top">0.99</td></tr><tr><td colspan="1" rowspan="1" align="left" valign="top"> group II (Hb >130 and 110 to 130 g/L)</td><td colspan="1" rowspan="1" align="char" char="." valign="top">1.20</td><td colspan="1" rowspan="1" align="center" valign="top">1.002 to 1.45</td><td colspan="1" rowspan="1" align="char" char="." valign="top">0.048</td></tr><tr><td colspan="1" rowspan="1" align="left" valign="top"> group IV (Hb 110 to 130 and <110 g/L)</td><td colspan="1" rowspan="1" align="char" char="." valign="top">1.62</td><td colspan="1" rowspan="1" align="center" valign="top">1.36 to 1.94</td><td colspan="1" rowspan="1" align="char" char="." valign="top"><0.001</td></tr><tr><td colspan="1" rowspan="1" align="left" valign="top"> group V (Hb <110 g/L)</td><td colspan="1" rowspan="1" align="char" char="." valign="top">1.85</td><td colspan="1" rowspan="1" align="center" valign="top">1.47 to 2.32</td><td colspan="1" rowspan="1" align="char" char="." valign="top"><0.001</td></tr><tr><td colspan="1" rowspan="1" align="left" valign="top"> group VI (Hb >130 and 110 to 130 and <110 g/L)</td><td colspan="1" rowspan="1" align="char" char="." valign="top">1.57</td><td colspan="1" rowspan="1" align="center" valign="top">1.24 to 1.98</td><td colspan="1" rowspan="1" align="char" char="." valign="top"><0.001</td></tr></tbody></table><table-wrap-foot><fn id="t4fn1"><label>a</label><p>ESA use during baseline period was not statistically significantly associated with mortality: Epoetins <italic>versus</italic> no ESA (HR 1.11; 95% CI 0.97 to 1.27); darbepoetin <italic>versus</italic> no ESA (HR 1.08; 95% CI 0.91 to 1.28); overall χ<sup>2</sup> = 2.39, <italic>P</italic> = 0.30.</p></fn></table-wrap-foot></table-wrap><table-wrap position="float" id="t5"><label>Table 5.</label><caption><p>OR of the factors that predict the degree of Hb variability (as defined by the highest quartile of residual SD) compared with those that are associated with Hb variability<xref ref-type="table-fn" rid="t5fn1">a</xref></p></caption><table frame="hsides" rules="groups"><thead><tr><th colspan="1" rowspan="2" align="center" valign="bottom">Variable</th><th colspan="2" rowspan="1" align="center" valign="bottom">Factors that Predict Hb Variability
<hr></hr></th><th colspan="2" rowspan="1" align="center" valign="bottom">Factors that Are Associated with Hb Variability
<hr></hr></th></tr><tr><th colspan="1" rowspan="1" align="center" valign="bottom">OR (95% CI)</th><th colspan="1" rowspan="1" align="center" valign="bottom"><italic>P</italic></th><th colspan="1" rowspan="1" align="center" valign="bottom">OR (95% CI)</th><th colspan="1" rowspan="1" align="center" valign="bottom"><italic>P</italic></th></tr></thead><tbody><tr><td colspan="1" rowspan="1" align="left" valign="top">Age (per 10 yr)</td><td colspan="1" rowspan="1" align="center" valign="top">0.90 (0.85 to 0.96)</td><td colspan="1" rowspan="1" align="char" char="." valign="top"><0.001</td><td colspan="1" rowspan="1" align="center" valign="top">0.89 (0.83 to 0.95)</td><td colspan="1" rowspan="1" align="char" char="." valign="top"><0.001</td></tr><tr><td colspan="1" rowspan="1" align="left" valign="top">Epoetins</td><td colspan="1" rowspan="1" align="center" valign="top">2.53 (2.00 to 3.19)</td><td colspan="1" rowspan="1" align="char" char="." valign="top"><0.001</td><td colspan="1" rowspan="1" align="center" valign="top">2.59 (1.98 to 3.38)</td><td colspan="1" rowspan="1" align="char" char="." valign="top"><0.001</td></tr><tr><td colspan="1" rowspan="1" align="left" valign="top">Darbepoetin</td><td colspan="1" rowspan="1" align="center" valign="top">4.12 (3.32 to 5.12)</td><td colspan="1" rowspan="1" align="char" char="." valign="top"><0.001</td><td colspan="1" rowspan="1" align="center" valign="top">3.24 (2.53 to 4.15)</td><td colspan="1" rowspan="1" align="char" char="." valign="top"><0.001</td></tr><tr><td colspan="1" rowspan="1" align="left" valign="top">Months on ESA (per 3 mo)</td><td colspan="1" rowspan="1" align="center" valign="top">0.95 (0.91 to 0.99)</td><td colspan="1" rowspan="1" align="char" char="." valign="top">0.035</td><td colspan="1" rowspan="1" align="center" valign="top">0.94 (0.86 to 0.99)</td><td colspan="1" rowspan="1" align="char" char="." valign="top">0.015</td></tr><tr><td colspan="1" rowspan="1" align="left" valign="top">Baseline GFR (per 5 ml/min)</td><td colspan="1" rowspan="1" align="center" valign="top">Not in model</td><td colspan="1" rowspan="1" align="center" valign="top"></td><td colspan="1" rowspan="1" align="center" valign="top">0.94 (0.89 to 0.99)</td><td colspan="1" rowspan="1" align="char" char="." valign="top">0.011</td></tr><tr><td colspan="1" rowspan="1" align="left" valign="top">Variability in GFR (ml/min)</td><td colspan="1" rowspan="1" align="center" valign="top">1.03 (1.001 to 1.06)</td><td colspan="1" rowspan="1" align="char" char="." valign="top">0.041</td><td colspan="1" rowspan="1" align="center" valign="top">1.19 (1.14 to 1.25)</td><td colspan="1" rowspan="1" align="char" char="." valign="top"><0.001</td></tr><tr><td colspan="1" rowspan="1" align="left" valign="top">Albumin (g/L)</td><td colspan="1" rowspan="1" align="center" valign="top">0.96 (0.94 to 0.97)</td><td colspan="1" rowspan="1" align="char" char="." valign="top"><0.001</td><td colspan="1" rowspan="1" align="center" valign="top">0.95 (0.93 to 0.98)</td><td colspan="1" rowspan="1" align="char" char="." valign="top"><0.001</td></tr><tr><td colspan="1" rowspan="1" align="left" valign="top">White cell count (×10<sup>9</sup>/L)</td><td colspan="1" rowspan="1" align="center" valign="top">1.020 (0.998 to 1.040)</td><td colspan="1" rowspan="1" align="char" char="." valign="top">0.083</td><td colspan="1" rowspan="1" align="center" valign="top">1.07 (1.04 to 1.11)</td><td colspan="1" rowspan="1" align="char" char="." valign="top"><0.001</td></tr><tr><td colspan="1" rowspan="1" align="left" valign="top">Transferrin saturation (%)</td><td colspan="1" rowspan="1" align="center" valign="top">Not in model</td><td colspan="1" rowspan="1" align="center" valign="top"></td><td colspan="1" rowspan="1" align="center" valign="top">3.45 (1.31 to 9.12)</td><td colspan="1" rowspan="1" align="char" char="." valign="top">0.013</td></tr></tbody></table><table-wrap-foot><fn id="t5fn1"><label>a</label><p>The values of factors 6 mo before the 6-mo baseline period were used in the model that examined the prediction of Hb variability; the values of factors during the 6-mo baseline period were used in the model that examined the association with Hb variability. OR, odds ratio.</p></fn></table-wrap-foot></table-wrap></floats-wrap></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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