Is anemia at hospital admission associated with in-hospital acute kidney injury occurrence?

Lilach Shema-Didi, Liora Ore, Ronit Geron, Batya Kristal

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18 Scopus citations


Background: The effect of acute kidney injury (AKI) on anemia has been well-documented. However, the effect of 'preexisting' anemia on AKI has been less addressed. The aims of the present study were to investigate (1) the association between anemia at hospital admission and AKI occurrence, and (2) the effect of 'preexisting' anemia on the clinical outcomes of AKI. Methods: A retrospective cohort study was undertaken among patients aged ≥17 years who were admitted to our hospital during the year 2006 (n = 34,802). Anemia at hospital admission and AKI occurrences were determined using the WHO definition and the RIFLE criteria, respectively. A subgroup of patients with an estimated glomerular filtration rate ≥60 ml/min/1.73 m2 was analyzed separately to control for the effect of chronic kidney disease on anemia. Results: The cumulative incidence of AKI was 11.2% in anemic patients at hospital admission, compared to 5.5% in nonanemic subjects. The association between anemia at admission and AKI occurrence remained statistically significant after controlling for potential confounders (odds ratio 1.5, 95% CI 1.4-1.6). In addition, an association between anemia at hospital admission and clinical outcomes of AKI was observed. Conclusion: Anemia at hospital admission should be recognized as a potential risk factor for in-hospital AKI occurrence.

Original languageEnglish
Pages (from-to)c168-c176
JournalNephron - Clinical Practice
Issue number2
StatePublished - Jun 2010
Externally publishedYes

Bibliographical note

Funding Information:
Funding: this work was supported by Institut National de la Santé et de la Recherche Médicale (INSERM), Centre National de la Recherche Scientifique (CNRS), Université Paris Sorbonne, grants from CoMETH-Recherche 2016, and Agence Nationale de la Recherche (ANR-07-MRAR-028-01). Appendix: SIPPET Study Group. S. Hanagavadi, Davangere, India; R. Varadarajan, Chennai, India; M. Karimi, Shiraz, Iran; M. V. Manglani, Mumbai, India; C. Ross, Bangalore, India; G. Young, Los Angeles, USA; T. Seth, New Delhi, India; S. Apte, Pune, India; D. M. Nayak, Karnataka, India; E. Santagostino, M. Elisa Mancuso, Milan, Italy; A. C. Sandoval Gonzalez, Monterrey, Mexico; J. N. Mahlangu, Johannesburg, South Africa; S. Bonanad Boix, Valencia, Spain; M. Cerqueira, Rio de Janeiro, Brazil; N. P. Ewing, Duarte, USA; C. Male, Vienna, Austria; T. Owaidah, Riyadh, Saudi Arabia; V. Soto Arellano, Fargo, USA; N. L. Kobrinsky, Jackson, USA; S. Majumdar, and R. Perez Garrido, Sevilla, Spain; A. Sachdeva, New Delhi, India; M. Simpson, Chicago, USA; M. Thomas, Kerala, India; E. Zanon, Padova, Italy; B. Antmen, Adana, Turkey; K. Kavakl, Izmir, Turkey; M. J. Manco-Johnson, Aurora, USA; M. Martinez, Buenos Aires, Argentina; E. Marzouka, Santiago, Chile; M. G. Mazzucconi, Rome, Italy; D. Neme, Buenos Aires, Argentina; A. Palomo Bravo, Malaga, Spain; R. Paredes Aguilera, Mexico City, Mexico; A. Prezotti, Vitoria, Brazil; K. Schmitt, Linz, Austria; B. M. Wicklund, Kansas City, USA; B. Zulfikar, Istanbul, Turkey.


  • Anemia
  • Hospitalization
  • Risk factors


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