A cohort study of the relationship between anaemia, mean corpuscular volume and mortality among a CKD population in South Africa

Abstract

Background: The burden of chronic kidney disease is increasing globally and prompt identification, coupled with improved management of CKD patients have increased the population of pre-dialysis patients. We, therefore, aimed to evaluate the predictors of survival among pre-dialysis CKD patients in South Africa.
 Methods: We conducted a cohort study of 256 consecutive consenting Black non-dialysis requiring CKD patients attending the renal outpatient clinic of a tertiary Hospital in South Africa from 1st June 2016 to 1st December 2016. Socio-demographic and clinical information of the participants were obtained. Descriptive statistics, Kaplan-Meier curves and Cox proportional hazard regression analyses were conducted to evaluate factors affecting the survival of the participants.
 Results: The mean age of the participants was 52.8±14.3 years and 48.0% were females, 52% were males. The death rate increased with worsening haemoglobin level from 0.96 among patients with mild anaemia to 4.29 per 100-person years among patients with severe anaemia. Anaemic patients with GFR < 30mls/min had significantly increased risk of death (HR 11.51, 95% CI 1.62–78.32, P < 0.001).
 Conclusion: Mortality in pre-dialysis CKD patients was associated with anaemia and hyperphosphatemia. Clinical interventions targeted at preventing these conditions may improve outcomes among this group of CKD patients.
 Keywords: Chronic kidney disease; mortality anaemia; outcomes, survival.

Hemodiyaliz Tedavisi Alan Erişkin Hastalarda Geriatrik Beslenme Risk İndeksi, Üre Azalma Oranı, Antropometrik Ölçümler ve Biyokimyasal Göstergeler Arasındaki İlişki: Kesitsel Bir Çalışma

“…CKD is a worldwide public health problem that not only makes a significant contribution to morbidity and mortality (4,5), but also imposes a significant financial burden on both patients and healthcare systems (6,7). The increased risk of morbidity and mortality in CKD patients may be due to the high cost of treatment or the level of kidney function (8).…”