Anemia of Chronic Kidney Disease: Pattern, Prevalence and Clinical Correlates. A Single Center Cross Sectional Study in South Western Nigeria

Abstract

Introduction: Anemia is a modifiable and very common complication of chronic kidney disease that could be difficult to manage, more so in low income settings due to late recognition, and cost of undergoing required investigations and treatment. Methods: A cross sectional study in which participants with chronic kidney disease and with glomerular filtration rate (GFR) <60ml/min had urine, blood and radiological investigations to determine albuminuria, GFR with electrolytes concentrations kidney length respectively. Results: One hundred and forty four (82 females and 62 females) cohorts participated. The mean age of all participants was 48.76 ± 15.87 years. Only cohorts in stage 5 CKD were receiving ESAs, and of the 22, 19 (86.3%) had anemia. The 45-59 years group had the highest blood pressure. A greater proportion of the participants had hypertension as the cause of CKD. The prevalence of anemia was 39.58%, 37.80% in males and 41.93% in females. The mean hemoglobin concentration for cohorts was 10.96 ± 1.85 g/dL, and was higher in males, P=0.06, and was least with chronic interstitial nephritis. Metabolic acidosis was commoner in females, P=0.04. Calcium x Posphate product was elevated in 10.5% of the participants. The mean serum creatinine was higher in males than females, P=0.001. The mean eGFR and urine ACR were higher in males, P=0.02, P=1.1. The severity of anemia was positively related to stage of CKD, P<0.001. Conclusion: Anemia complicating CKD is common, with a prevalence of 39.58% in our study. It was commoner in females, aged and elevated urine ACR and was negatively correlated with serum albumin. Determinants of renal anemia were age, and kidney function while predictors were increasing age, stage 5 CKD and urine ACR. Improvement in kidney function, frequent reviews of red cell indices and medications are needed to minimize complications of renal anemia. Key words: anemia, chronic kidney disease, erythropoiesis stimulating agents, hemoglobin concentration,