{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T09:23:32Z","timestamp":1785317012881,"version":"3.55.0"},"reference-count":20,"publisher":"S.C. JURNALUL PENTRU MEDICINA SI VIATA S.R.L","issue":"4","license":[{"start":{"date-parts":[[2018,10,1]],"date-time":"2018-10-01T00:00:00Z","timestamp":1538352000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMedLife"],"abstract":"<jats:sec>\n<jats:title>Rationale<\/jats:title>\n<jats:p>Anemia, a common feature in chronic kidney disease (CKD), has multiple contributors to its pathogenesis. Besides the well recognized erythropoietin and iron deficiencies, hydration status might be involved.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Objective<\/jats:title>\n<jats:p>To assess the prevalence and correlations of anemia, iron deficiency and overhydration in patients with stage 2 to 5 CKD.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Methods and Results<\/jats:title>\n<jats:p>This cross-sectional study enrolled 125 erythropoietin and iron therapy na\u00efve non-dialysis CKD patients, without a identifiable cause of anemia.<\/jats:p>\n<jats:p>Parameters of hematological, iron, inflammatory and nutritional status were measured. The overhydration parameter (OH) assessed by bioimpedance spectroscopy was used to characterize hydration status.<\/jats:p>\n<jats:p>The prevalence of decreased hemoglobin (Hb) &lt;110g\/L increased along CKD stages from 0% to 40% (<jats:italic>p<\/jats:italic>=0.008). Fluid overload (OH &gt;1L) and lower serum albumin (&lt;40g\/L) were more common in stage 5 versus stage 3 CKD (53% vs. 10%, <jats:italic>p<\/jats:italic>&lt;0.001, and 27% vs. 3%, <jats:italic>p<\/jats:italic>=0.02, respectively), suggesting a potential dilutional reduction in serum proteins. Conversely, decreased iron stores (ferritin &lt;100mcg\/L) and iron availability (transferrin saturation, TSAT&lt;0.20) were similarly prevalent irrespective of kidney function decline.<\/jats:p>\n<jats:p>Hemoglobin was positively correlated with estimated glomerular filtration rate (eGFR), serum albumin, and transferrin saturation, but inversely with OH. However, in a model of multiple linear regression which explained 32% of hemoglobin variation, only eGFR and overhydration remained the independent predictors of anemia.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Discussion<\/jats:title>\n<jats:p>As fluid overload is a common denominator for hemoglobin and TSAT levels, and is closely related to the declining kidney function, it should be considered in the management of renal anemia, at least in advanced CKD.<\/jats:p>\n<\/jats:sec>","DOI":"10.25122\/jml-2019-0002","type":"journal-article","created":{"date-parts":[[2022,11,17]],"date-time":"2022-11-17T07:49:21Z","timestamp":1668671361000},"page":"293-298","source":"Crossref","is-referenced-by-count":6,"title":["Renal anemia and hydration status in non-dialysis chronic kidney disease: Is there a link?"],"prefix":"10.25122","volume":"11","author":[{"given":"Simona","family":"Hildegard Stancu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"\u201cCarol Davila\u201d University of Medicine and Pharmacy, Nephrology Dept., Bucharest, Romania","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"\u201cDr. Carol Davila\u201d Teaching Hospital of Nephrology, Bucharest, Romania","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Stanciu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"\u201cDr. Carol Davila\u201d Teaching Hospital of Nephrology, Bucharest, Romania","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariana","family":"Lipan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"\u201cDr. Carol Davila\u201d Teaching Hospital of Nephrology, Bucharest, Romania","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Capusa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"\u201cCarol Davila\u201d University of Medicine and Pharmacy, Nephrology Dept., Bucharest, Romania","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"\u201cDr. Carol Davila\u201d Teaching Hospital of Nephrology, Bucharest, Romania","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Assoc. Prof. Cristina Capusa, \u201cDr. Carol Davila\u201d Teaching Hospital of Nephrology, 4 Calea Grivitei, District 1, 010731, Bucharest, Romania Phone \/ Fax: 021-3129226, E-mail: ccalexandr@yahoo.com","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10755","published-online":{"date-parts":[[2018,10]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","unstructured":"Fishbane S, Spinowitz B. Update on anemia in ESRD and earlier stages of CKD: Core Curriculum 2018. Am J Kidney Dis. 2018; 71(3): 423\u2013435","DOI":"10.1053\/j.ajkd.2017.09.026"},{"key":"ref2","doi-asserted-by":"crossref","unstructured":"Babitt JL, Lin HY. Mechanisms of anemia in chronic kidney disease. J Am Soc Nephrol. 2012; 23(10): 1631\u20131634","DOI":"10.1681\/ASN.2011111078"},{"key":"ref3","unstructured":"H\u00f6rl WH. Iron therapy in patients with Chronic Kidney Disease: Taking the high road? 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Kidney Int. 2014; 85(3): 703\u2013709","DOI":"10.1038\/ki.2013.336"}],"container-title":["Journal of Medicine and Life"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/medandlife.org\/wp-content\/uploads\/JMedLife-11-293.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,11,17]],"date-time":"2022-11-17T07:49:37Z","timestamp":1668671377000},"score":1,"resource":{"primary":{"URL":"https:\/\/medandlife.org\/wp-content\/uploads\/JMedLife-11-293.pdf"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,10]]},"references-count":20,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2018,10]]}},"alternative-id":["JMedLife-11-293"],"URL":"https:\/\/doi.org\/10.25122\/jml-2019-0002","relation":{},"ISSN":["1844-122X","1844-3117"],"issn-type":[{"value":"1844-122X","type":"print"},{"value":"1844-3117","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,10]]}}}