Hospitalization and 1-year all-cause mortality in type 2 diabetic patients with chronic kidney disease at Stages 1 and 2: Effect of mild anemia

Background: The effect of anemia in advanced chronic kidney disease (CKD) on morbidity and mortality is known. The aim of the present study was to assess the effect of mild anemia on hospitalization and 1-year all-cause mortality in type 2 diabetes mellitus (T2DM) patients with Stage 1 and 2 CKD. Methods: Hospitalized T2DM patients (n = 307) with a glomerular filtration rate ≥ 60 mL/min per 1.73 m² and urinary albumin excretion > 30 mg/24 h (Stage 1 and 2 CKD) were enrolled in the study and divided into two groups based on hemoglobin (Hb) concentrations: those with (mean [ ± SD] Hb 10.7 ± 0.7 g/dL) and without (mean Hb 13.3 ± 1.28 g/dL) anemia. Results: There was no significant difference between patients with and without anemia in terms of age, gender, body mass index, HbA1c, and cardiovascular diseases. The mean length of hospitalization of the 130 anemic and 177 non-anemic patients was 4.3 ± 3.5 and 3.5 ± 1.9 days, respectively (P < 0.001). Twelve anemic patients died within 1 year, compared with three patients without anemia (9.2% vs 1.7%, respectively; P = 0.002). After adjusting for confounding variables, multivariate Cox regression analysis revealed that mild anemia was significantly associated with 1-year all-cause mortality (hazard ratio 2.15, 95% confidence interval 1.92–2.54; P = 0.033). Conclusions: Mild anemia may increase the length of hospitalization and was associated with 1-year all-cause mortality among hospitalized T2DM patients with Stage 1 and 2 CKD.