Total IgG Concentration Linked to Anemia in Hemodialysis Patients

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Frontiers in Medicine Published April 16, 2026 Medically reviewed April 25, 2026 Study authors: Ibrahim A. Sandokji, Waleed H. Mahallawi, Saeed A. Alqahtani DOI ↗ By Dr. Amelia Tan, PhD · Internal Medicine & Chronic Disease

Key Takeaway

Recognize that total IgG concentration is associated with anemia in dialysis patients, but this cross-sectional finding is not causal.

This cross-sectional study evaluated 351 participants, including 179 dialysis patients and 172 healthy controls. The investigation focused on the associations of total immunoglobulin G (IgG) concentration and varicella zoster virus (VZV) serostatus with anemia in this population.

The study population included dialysis patients and healthy controls. Dialysis patients were older, with a median age of 47 years compared to 34 years in healthy controls (p value reported).

The primary finding was that total IgG concentration was strongly associated with anemia. In contrast, VZV-specific serostatus demonstrated only a minimal independent association with anemia. The study did not report specific effect sizes, absolute numbers, or confidence intervals for these primary associations.

No safety, tolerability, or adverse event data were reported, as this was not an interventional trial. The authors note that this investigation is hypothesis-generating and that prospective studies are needed to validate these associations and explore underlying mechanisms.

These observational findings do not establish a causal relationship between total IgG levels and anemia in dialysis patients. The results should be interpreted cautiously, and the association requires confirmation in prospective research before any clinical implications can be considered.

Study Details

Study typeCohort

EvidenceLevel 3

PublishedApr 2026

View Original Abstract ↓

Anemia affects up to 85% of hemodialysis patients and is associated with increased morbidity and mortality. Immune dysfunction in end-stage renal disease (ESRD) may contribute to anemia through inflammatory pathways. This exploratory study used machine learning to investigate associations between immune markers, particularly total immunoglobulin G (IgG) concentration and varicella zoster virus (VZV) serostatus, and anemia in dialysis patients. This cross-sectional study enrolled 351 participants (179 dialysis patients, 172 healthy controls) between November 2023 and February 2024. Demographic and clinical characteristics were compared using conventional statistics. Within the dialysis cohort, seven machine learning classification models were trained to identify correlates of anemia (hemoglobin Dialysis patients were older (median 47 vs. 34 years, p These findings suggest that total IgG concentration, a marker of broader immune activation, is strongly associated with anemia in dialysis patients, whereas VZV-specific serostatus shows minimal independent association. The results should be interpreted as hypothesis-generating, and prospective studies are needed to validate these associations and explore underlying mechanisms.