Impact of anemia requiring transfusion or erythropoiesis-stimulating agents on new-onset cardiovascular events and mortality after continuous renal replacement therapy

Sci Rep. 2024 Mar 19;14(1):6556. doi: 10.1038/s41598-024-56772-1.

Abstract

Anemia is common in critically ill patients undergoing continuous renal replacement therapy (CRRT). We investigated the impact of anemia requiring red blood cell (RBC) transfusion or erythropoiesis-stimulating agents (ESAs) on patient outcomes after hospital discharge in critically ill patients with acute kidney injury (AKI) requiring CRRT. In this retrospective cohort study using the Health Insurance Review and Assessment database of South Korea, 10,923 adult patients who received CRRT for 3 days or more between 2010 and 2019 and discharged alive were included. Anemia was defined as the need for RBC transfusion or ESAs. Outcomes included cardiovascular events (CVEs) and all-cause mortality after discharge. The anemia group showed a tendency to be older with more females and had more comorbidities compared to the control group. Anemia was not associated with an increased risk of CVEs (adjusted hazard ratio [aHR]: 1.05; 95% confidence interval [CI]: 0.85-1.29), but was associated with an increased risk of all-cause mortality (aHR: 1.41; 95% CI 1.30-1.53). For critically ill patients with AKI requiring CRRT, anemia, defined as requirement for RBC transfusion or ESAs, may increase the long-term risk of all-cause mortality.

Keywords: Anemia; Cardiovascular events; Continuous renal replacement therapy; Critical illness; Mortality.

MeSH terms

  • Acute Kidney Injury* / therapy
  • Adult
  • Anemia* / complications
  • Anemia* / drug therapy
  • Cardiovascular Diseases*
  • Continuous Renal Replacement Therapy*
  • Critical Illness
  • Erythropoiesis
  • Female
  • Hematinics* / therapeutic use
  • Humans
  • Retrospective Studies

Substances

  • Hematinics