Is anemia at hospital admission associated with in-hospital acute kidney injury occurrence?

Lilach Shema-Didi, Liora Ore, Ronit Geron, Batya Kristal

Research output: Contribution to journalArticlepeer-review


Background: The effect of acute kidney injury (AKI) on anemia has been well-documented. However, the effect of 'preexisting' anemia on AKI has been less addressed. The aims of the present study were to investigate (1) the association between anemia at hospital admission and AKI occurrence, and (2) the effect of 'preexisting' anemia on the clinical outcomes of AKI. Methods: A retrospective cohort study was undertaken among patients aged ≥17 years who were admitted to our hospital during the year 2006 (n = 34,802). Anemia at hospital admission and AKI occurrences were determined using the WHO definition and the RIFLE criteria, respectively. A subgroup of patients with an estimated glomerular filtration rate ≥60 ml/min/1.73 m2 was analyzed separately to control for the effect of chronic kidney disease on anemia. Results: The cumulative incidence of AKI was 11.2% in anemic patients at hospital admission, compared to 5.5% in nonanemic subjects. The association between anemia at admission and AKI occurrence remained statistically significant after controlling for potential confounders (odds ratio 1.5, 95% CI 1.4-1.6). In addition, an association between anemia at hospital admission and clinical outcomes of AKI was observed. Conclusion: Anemia at hospital admission should be recognized as a potential risk factor for in-hospital AKI occurrence.

Original languageEnglish
Pages (from-to)c168-c176
JournalNephron - Clinical Practice
Issue number2
StatePublished - Jun 2010

Bibliographical note

Funding Information:
The author would like to thank the Norwegian Research Council for Technical and Scientific Research, NTNF, and Statoil (VISTA) for funding research on sandstone diagenesis. The writer is also indebted to the Department of Earth Sciences, University of California, Santa Barbara, for working facilities during sabbatical year 1981 - 1982. Drs. J. Boles, Dave Price, K.H. Wolf, and George V. Chilingar have kindly read and improved this manuscript. I would also like to thank Dr. W.F. Galloway for interesting discussions on Gulf Coast geology and for providing data on the Frio Formation.


  • Anemia
  • Hospitalization
  • Risk factors

ASJC Scopus subject areas

  • Nephrology


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