TSUCHIYA Ken    Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine    Position   Professor (Fixed Term)
Language	English
Title	Sex and Aging Influence the Association between Kidney Prognosis and Anemia in Patients with ADPKD: Attribute-Based Medicine (ABM) Insights
Conference	Kidney Week 2024
Promoters	American Society of Nephrology
Conference Type	International society and overseas society
Presentation Type	Poster notice
Lecture Type	General
Publisher and common publisher	◎Tsuchiya Ken, Kataoka Hiroshi, Manabe Shun, Ushio Yusuke, Seki Momoko, Nitta Kosaku, Mochizuki Toshio, Hoshino Junichi,
Date	2024/10/24
Country	United States
Venue (city and name of the country)	San Diego, USA
Holding period	2024/10/24～2024/10/27
Summary	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.