{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T14:01:55Z","timestamp":1777903315176,"version":"3.51.4"},"reference-count":0,"publisher":"Hematology Section, Dept. of Radiological Science and Hematology, Catholic University, Rome, Italy","issue":"1","license":[{"start":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:00:00Z","timestamp":1777507200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Mediterr J Hematol Infect Dis"],"abstract":"<jats:p>Background: In non-dialysis chronic kidney disease (ND-CKD), anemia, frailty, and cardiovascular (CV) complications intersect, yet the prognostic relevance of within-patient hemoglobin (Hb) change over time remains unclear. We tested whether distinct 12-month Hb trajectories patterns are associated with frailty worsening and CV events.\nMethods: Adults with stage 3\u20135 ND-CKD and renal anemia (men &lt;13 g\/dL; women &lt;12 g\/dL) were enrolled at a single center (June\u2013December 2023) and followed monthly for 12 months. Hb was measured monthly. Latent-class mixed models were used to derive stable, declining, and fluctuating Hb trajectories from all available Hb measurements during follow-up. Frailty was assessed at baseline, 6 months, and 12 months. Frailty worsening was prespecified as a \u22651-point increase in FRAIL score or new onset of weak grip or slow gait. Associations were evaluated using mixed-effects logistic regression (frailty worsening) and cause-specific Cox models (time-to-first composite CV event), adjusting for key clinical covariates.\nResults: Follow-up at 12 months were available for 182\/190 (95.8%) participants. Trajectory allocation was 39% stable, 41% declining (mean slope \u22120.18 g\/dL\/month), and 20% fluctuating (higher within-person variability). Frailty worsened in 57% of declining, 45% of fluctuating, and 25% of stable participants. Adjusted odds ratios versus Stable were 2.8 (95% CI 1.6\u20135.0) for Declining and 1.9 (0.9\u20134.0) for Fluctuating. Over 185 person-years, 46 composite CV events occurred (24.9\/100 person-years), and adjusted hazard ratios were 2.6 (1.4\u20134.9) for Declining and 1.7 (0.8\u20133.6) for Fluctuating.\nConclusion: A 12-month Declining Hb trajectory was independently associated with substantially higher odds of frailty worsening and higher hazard of CV events compared with a Stable profile, whereas a Fluctuating pattern showed intermediate, non-significant associations. Longitudinal Hb trend monitoring may help identify ND-CKD patients who warrant closer anemia evaluation alongside frailty-focused interventions.<\/jats:p>","DOI":"10.4084\/mjhid.2026.040","type":"journal-article","created":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T11:56:12Z","timestamp":1777636572000},"page":"e2026040","source":"Crossref","is-referenced-by-count":0,"title":["DYNAMIC HEMOGLOBIN TRAJECTORIES IN RENAL ANEMIA AND THEIR ASSOCIATION WITH FRAILTY PROGRESSION AND CARDIOVASCULAR EVENTS IN NON\u2011DIALYSIS CHRONIC KIDNEY DISEASE"],"prefix":"10.4084","volume":"18","author":[{"given":"Li","family":"Guo","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lei","family":"Ran","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhen-Zhen","family":"Hao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ya-Pu","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jian-Dong","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shan-Shan","family":"Guo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2554","published-online":{"date-parts":[[2026,4,30]]},"container-title":["Mediterranean Journal of Hematology and Infectious Diseases"],"original-title":[],"link":[{"URL":"https:\/\/www.mjhid.org\/mjhid\/article\/download\/6270\/4876","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.mjhid.org\/mjhid\/article\/download\/6270\/4884","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.mjhid.org\/mjhid\/article\/download\/6270\/4876","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T11:56:12Z","timestamp":1777636572000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mjhid.org\/mjhid\/article\/view\/6270"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,30]]},"references-count":0,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1,1]]}},"URL":"https:\/\/doi.org\/10.4084\/mjhid.2026.040","relation":{},"ISSN":["2035-3006"],"issn-type":[{"value":"2035-3006","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,30]]}}}