ホシノ　ジユンイチ   Hoshino Jiyun'ichi   星野　純一    所属   医学部 医学科（東京女子医科大学病院）    職種   教授・基幹分野長
言語種別	英語
発表タイトル	Association of Anemia (Hemoglobin <13 g/dL in Men and <12 g/dL in Women) with Long-Term Kidney Prognosis in Patients with ADPKD: Insights from Time Series Analyses
会議名	Kidney Week 2024
主催者	American Society of Nephrology
学会区分	国際学会及び海外の学会
発表形式	ポスター掲示
講演区分	一般
発表者・共同発表者	◎Kataoka Hiroshi, Mochizuki Toshio, Manabe Shun, Ushio Yusuke, Seki Momoko, Tsuchiya Ken, Nitta Kosaku, Hoshino Junichi,
発表年月日	2024/10/24
国名	アメリカ合衆国
開催地 （都市, 国名）	San Diego, USA
開催期間	2024/10/24～2024/10/27
概要	Background Hemoglobin (Hb) levels are generally higher in autosomal dominant polycystic kidney disease (ADPKD) compared to other kidney diseases, but the prognostic role of anemia in ADPKD is not well understood. Prognostic factors for kidney outcomes can vary with the length of follow-up periods, making it crucial to understand the time-series changes and integrals of pseudo-R2 values for kidney risk factors. Methods We enrolled 553 ADPKD patients. Renal outcome was defined as a 50% reduction in estimated glomerular filtration rate or initiation of renal replacement therapy. Survival analyses and logistic regression analyses for generating time-series pseudo-R2 values were conducted. The integrated values of the pseudo-R2 values from the 1st year to the 17th year (1Y–17Y Integrals) were calculated to determine the optimal Hb cut-off points for long-term renal prognosis. Results Multivariable Cox analyses indicated that anemia (Hb 1 g/L decrease, P=0.0004) was associated with kidney disease progression. To determine the anemia cut-off for kidney prognosis, pseudo-R2 values for Hb <12 g/dL showed the highest 1Y–17Y integrals of 1.88 among all anemia cut-offs. These values peaked at 0.2401 two years after baseline and had the highest end value of 0.0721 at 17 years. Therefore, Hb <12 g/dL was identified as a key indicator of long-term kidney prognosis in ADPKD patients. Similar sex-specific analyses revealed different anemia cut-offs: Hb <13 g/dL in men and Hb <12 g/dL in women. Conclusion The 1Y–17Y Integrals of the pseudo-R2 values for kidney prognosis contributed to determining the cut-off points of the anemia according to the sex difference.