Anemia is a common symptom for chronic kidney disease (CKD), but there hasn’t been much research done on the association between the two or the adverse outcomes which ensue as a result of anemia for this patient population. Dr. Robert Minutolo and his colleagues aimed to fill this gap by conducting a combined analysis of 3 different observational studies.
The Study
This pooled study included 1,031 CKD patients who did not have anemia. All patients had an eGFR of less than 60 and had been regularly monitored in renal clinics. Participants were an average of 63 years old, and 20% were diagnosed with diabetes. Additionally, 60% were male. The median proteinuria of participants was .4 g/day, and the average eGFR was 37 mL/min/1.73 m2.
The researchers worked to estimate the incidence of both mild and severe anemia as well as the risk of developing end-stage kidney disease (ESKD) and death which may be associated with anemia. These were estimated over a three year period.
It was estimated that the incidence of mild anemia was 13.7/100 patient years. Severe anemia was estimated to be 6.2/100 patient years. The team found predictors of anemia (mild or severe in nature) were high levels of serum phosphate, low hemoglobin, diabetes, an eGFR of 30, as well as proteinuria of more than .5 g/day. They also found that being male, having moderate proteinuria, and having moderate CKD, was associated with mild anemia only. Anemia increased as patients progressed in CKD stages and as they increased in proteinuria. Those who had mild or severe anemia also presented with a higher risk of ESKD as well as death.
These results demonstrate the importance of closely examining anemia in CKD patients. Anemia is common in individuals with CKD, especially those who have diabetes and those who have more severe levels of renal damage. Even mild anemia may lead to worse outcomes for patients and a higher risk of ESKD. It is clear more research in this area is needed.
The results of this study were published in the Clinical Kidney Journal.
You can read more about this investigation and anemia in CKD here.
