マナベ　シユン   Manabe Shiyun   眞部　俊    所属   医学部 医学科（東京女子医科大学病院）    職種   講師
言語種別	英語
発表タイトル	Sex and Aging Influence the Association between Kidney Prognosis and Anemia in Patients with ADPKD: Attribute-Based Medicine (ABM) Insights
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	◎Tsuchiya Ken, Kataoka Hiroshi, Manabe Shun, Ushio Yusuke, Seki Momoko, Nitta Kosaku, Mochizuki Toshio, 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 Although anemia is traditionally considered a marker of poor renal prognosis in CKD, the significance and the prognostic role of anemia in ADPKD remains clearly unexplored. Recently, the significance of ABM has been underscored, and the effects of anemia on CKD progression may differ between young male and elderly female patients with ADPKD. We aimed to examine the effects of sex and aging to CKD progression of ADPKD using various levels of anemia. Methods We enrolled 553 ADPKD patients. Renal outcome, defined as a 30% reduction in eGFR or initiation of renal replacement therapy, was assessed using Cox regression analysis. Five thresholds of anemia were considered: 1) Hb <12 g/dL in men and Hb<11 g/dL in women; 2) Hb<13 g/dL in men and Hb<12 g/dL in women; 3) Hb<11 g/dL; 4) Hb<12 g/dL; 5) Hb<13g/dL. For subgroup analyses, cross-classification (4 groups) of sex × 50 years was also used for analyses per attribute. Results The cohort’s median age was 43 years old, with median eGFR of 55.9 mL/min/1.73 m2, and a median total kidney volume of 1335.4 ml. Over a median follow-up period was 9.1 years, renal outcomes were observed in 236 patients. Multivariable Cox analyses revealed that anemia (2: Hb<13.0 g/dL in men, Hb<12.0 g/dL in women; HR=1.81, P=0.0004) had the strongest association with kidney disease progression in the entire cohort. Subgroup analyses showed significant associations between kidney disease progression and anemia (5: Hb<13.0 g/dL; HR=3.46 in men <50 years old, HR=3.11 in men ≥50 years old), anemia (4: Hb<12.0 g/dL; HR=2.00 in men <50 years old), and anemia (3: Hb<11.0 g/dL; HR= 2.18 in women ≥50 years old). Conclusion In ADPKD patients, a higher threshold for anemia (Hb<13.0 g/dL in men, Hb<12.0 g/dL in women) was associated with kidney prognosis. Furthermore, cross-classification analysis revealed differential associations between higher thresholds of anemia and renal prognosis in male and younger patients, while a lower threshold (Hb<11.0 g/dL) was associated with renal prognosis in elderly women (women ≥50 years old). These findings underscore the utility of ABM care, employing cross-classification, in managing anemia in ADPKD patients.