The influence of kidney size on hemoglobin level in CKD patients

Anemia is common among patients with chronic kidney disease (CKD), and it is associated with increased morbidity and mortality [1]. Previous studies associated the hemoglobin level in CKD patients with the glomerular filtration rate (GFR) [1, 2]. In this study, we investigated the association between kidney size (demonstrated by kidney length) and hemoglobin level in CKD patients. The study was conducted in a total of 68 CKD patients, who were recruited from Prince Hamzah Hospital (Amman, Jordan) and Praxisklinik/Dialysezentrum (Herne, Germany). Patients who were on hemodialysis, taking Erythropoietin, or with anemia due to other known underlying causes such as iron deficiency, folate deficiency, or chronic illnesses were excluded. Pearson correlation showed a positive correlation between hemoglobin level and kidney length (p-value = 0.002). ROC curve showed that kidney length could be a good predictor of hemoglobin (AUC = 0.69). Anemic patients with CKD have smaller kidneys compared to the general population (p = 0.002). Our study demonstrated a clear and statically significant relation between kidney length and hemoglobin level in patients with CKD. This result can be of clinical significance, as it may help in prediction and thus early treatment of erythropoietin deficiency anemia in CKD patients, which can improve the quality of life and reduce mortality, which is mainly due to ischemic heart disease (IHD)secondary to left ventricular hypertrophy (LVH) [3].